Reversal Surgery for Split Stoma with Peristomal Incision is Associated with Improved Postoperative Outcome in Patients with Crohn's Disease.

IF 2.1 4区医学 Q2 SURGERY

Journal of Investigative Surgery Pub Date : 2024-12-01 Epub Date: 2024-06-11 DOI:10.1080/08941939.2024.2363179

Shixian Wang, Kangling Du, Ming Duan, Yihan Xu, Zhen Guo, Jianfeng Gong, Weiming Zhu, Yi Li

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引用次数: 0

Abstract

Background: Temporary stoma formation is common in Crohn's disease (CD), while stoma reversal is associated with postoperative morbidity. This study aimed to evaluate the postoperative outcomes of split stoma reversal, SSR (i.e., exteriorization of proximal and distal ends of the stoma through a small common opening) and end stoma closure, ESC (i.e., the proximal stump externalized, and distal end localized abdominally.

Methods: Patients with CD who underwent stoma reversal surgeries between January 2017 and December 2021 were included. Demographic, clinical, and postoperative data were collected and analyzed to evaluate outcomes of reversal surgery.

Results: A total of 255 patients who underwent stoma reversal surgeries met the inclusion criteria. SSR was superior to ESC in terms of operative time (80.0 vs. 120.0, p = 0.0004), intraoperative blood loss volume (20.0 vs. 100.0, p = 0.0002), incision length (3.0 vs. 15.0, p < 0.0001), surgical wound classification (0 vs. 8.3%, p = 0.04), postoperative hospital stay (7.0 vs. 9.0, p = 0.0007), hospital expense (45.6 vs. 54.2, p = 0.0003), and postoperative complications (23.8% vs. 44.3%, p = 0.0040). Although patients in the ESC group experienced more surgical recurrence than those in the SSR group (8.3% vs. 3.2%) during the follow-up, the Kaplan-Meier curve analysis revealed no statistical difference (p = 0.29).

Conclusions: The split stoma can be recommended when stoma construction is indicated in patients with Crohn's disease.

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利用肛周切口逆转分隔造口手术可改善克罗恩病患者的术后效果。

背景：临时造口的形成在克罗恩病（CD）中很常见，而造口翻转与术后发病率有关。本研究旨在评估分体式造口翻转术（SSR，即通过一个小的共同开口将造口的近端和远端外部化）和造口末端关闭术（ESC，即近端残端外部化，远端腹部局部化）的术后效果：纳入2017年1月至2021年12月期间接受造口翻转手术的CD患者。收集并分析人口统计学、临床和术后数据，以评估造口翻转手术的结果：共有255名接受造口翻转手术的患者符合纳入标准。在手术时间（80.0 对 120.0，P = 0.0004）、术中失血量（20.0 对 100.0，P = 0.0002）、切口长度（3.0 对 15.0，P = 0.04）方面，SSR 均优于 ESC。0，p = 0.04）、术后住院时间（7.0 vs. 9.0，p = 0.0007）、住院费用（45.6 vs. 54.2，p = 0.0003）和术后并发症（23.8% vs. 44.3%，p = 0.0040）。虽然ESC组患者在随访期间的手术复发率（8.3% vs. 3.2%）高于SSR组，但Kaplan-Meier曲线分析显示两者没有统计学差异（p = 0.29）：结论：当需要为克罗恩病患者建造造口时，可推荐使用分体式造口。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of Investigative Surgery 医学-外科

CiteScore

4.20

自引率

0.00%

发文量

114

审稿时长

6-12 weeks

期刊介绍： Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.