結腸造口術及閉合術的合併症

Complications of Colostomies and Colostomy Closure

黃勇福(Yeong-Fwu Hwang) ； 陳壽星(Show-Shing Chen) ； 劉添裕(Tian-Yuh Liou) ； 王輝明(Hwei-Ming Wang) ； 徐弘(Hung Hsu)

《The Kaohsiung Journal of Medical Sciences》 6卷6期 (1990/06) Pp. 276-282

https://doi.org/10.6452/KJMS.199006.0276

摘要

7年間有360位病人共作了369例結腸造口術，平均追蹤時間是20個月，其中66例為良性，303例是惡性疾病；經由常規手術的有246例，緊急手術有123例；結腸造口位於傷口切開位置（incisional site）有37例，在分離位置（sparated site）有332例。造口術的型式終端造口術179例，環狀造口術有136例雙桶造口術有54例。共有85位病人發生102例（27.6%）的合併症，其中以傷口鍶染為最多（10.8%）；合併症的產生與手術時機、疾病性質或造口的位置並無相關性，但在傷口感染率方面，造口位於切開位置比分離位置來得高，終端造口術以腹膜外法，未能降低造口旁疝氣或腸阻塞合併症的產生。合併症需再以手術矯正的有　16例，佔4.3%。
有85位病人作結腸造口閉合的手術，從造口術到閉合術的期間平均為3.4個月，其中有4位病人產生5例合併症（5.9%），有2例需再以手術矯正；其中閉合哈特曼式結腸造口術比閉合環狀結腸造口術有較高比例的合併症，又合併症的發生與閉合結腸造口時間有相關性。

並列摘要

Three hundred and sixty patients underwent 369 colostomies over 7 years, 66 for benign and 303 for malignant disease, and were followed up for an average of 20 months. Stomas were made electively in 246 cases and urgently in 123. Thirty-seven stomas were brought out through incision and 332 from separate sites. End colostomy was made in 179 cases, loop colostomy in 136 and double barrel colostomy in 54, There were 102 complications in 85 patients (27.6%). The most common complication was wound infection (10.8%). The total number of complications was not related to the urgency of the procedure, the disease process, or the stoma site. Wound infection, however, increased in incisional stomas. Extraperitoneal tunneling of end colostomy did not decrease the complication rate of parastomal hernia or intestinal obstruction. Sixteen cases (4.3%) received another operation for complications.
Eighty-five patients the colostomy closed on an average of 3.4 months after its creation. Four patients required another operation. Complications increased with Hartmann closures and may be related to the timing of the colostomy closure.

並列關鍵字

colostomy ； colostomy closure ； complications