憩室造口对肾功能的影响

IF 3.2 2区 医学 Q2 GASTROENTEROLOGY & HEPATOLOGY
Takuki Yagyu,Madoka Hamada,Masahiko Hatta,Toshinori Kobayashi,Yuki Matsumi,Ryo Inada,Tomoko Matsumoto,Masaharu Oishi
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引用次数: 0

摘要

背景虽然襻式回肠造口术作为一种分流造口被认为会影响肾功能障碍,但很少有报告对襻式结肠造口术和襻式回肠造口术的肾功能进行比较。本研究旨在揭示保留括约肌直肠手术后,回肠造口术与结肠造口术相比对肾功能障碍的影响。设计本研究为回顾性分析。我们比较了术前和术后血尿素氮、血清肌酐和肾小球滤过率的估计值。主要结果测量术前患有慢性肾病的患者术前和术后肾功能值在造口部位上的差异。结果在术前慢性肾脏病(+)患者中,血尿素氮(P = 0.047)和血清肌酐(P = 0.028)值在术前和术后的差异高于术前慢性肾脏病(-)患者。在术前慢性肾脏病(+)患者中,与结肠造口术相比,回肠造口术与血清肌酐值升高(P = 0.025)和估计肾小球滤过率值下降(P = 0.041)显著相关。在多变量分析中,回肠造口术(几率比;7.443,p = 0.011)和高血压(4.226,p = 0.008)是术后新发肾病的独立风险因素。结论我们应谨慎选择分流造口,尤其是有肾功能障碍风险的患者。参见视频摘要。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Impact of the Diverting Stoma on Renal Function.
BACKGROUND Although loop ileostomy as a diverting stoma has been considered to affect renal dysfunction, few reports have compared loop colostomy with loop ileostomy regarding renal function. This is an important issue in the current setting of increased opportunities to perform surgery on patients with poor renal function. OBJECTIVE This study aims to reveal the effect of ileostomy on renal dysfunction compared to colostomy following sphincter-preserving rectal surgery. DESIGN This study was a retrospective analysis. We compared preoperative and postoperative blood urea nitrogen, serum creatinine and estimated glomerular filtration rate values. SETTINGS The study was conducted at a single academic institution in Osaka, Japan. PATIENTS From October 2013 to November 2021, 135 consecutive patients underwent rectal surgery with diverting stoma are included. MAIN OUTCOME MEASURES Differences in pre- and postoperative renal function values by stoma creation site in patients with preoperative chronic kidney disease. Risk factors for patients with newly kidney disease after stoma creation. RESULTS In the preoperative chronic kidney disease (+) patients, the differences between the pre- and post-values in the blood urea nitrogen (p = 0.047) and the serum creatinine (P = 0.028) values were higher than in the preoperative chronic kidney disease (-) patients. In the preoperative chronic kidney disease (+) patients, ileostomy was significantly associated with an elevation of the serum creatinine value (p = 0.025) and a decrease in estimated glomerular filtration rate value (p = 0.041) from the pre-operative one compared with that of colostomy. In multivariate analysis, ileostomy (odds ratio; 7.443, p = 0.011) and hypertension (4.226, p = 0.008) were independent risk factors of newly kidney disease postoperatively. LIMITATIONS Limitations to our study includes its retrospective nature and bias due to the stoma site being determined by each surgeon. CONCLUSION We should take care to choose diverting stoma especially in patients with a risk of kidney disfunction. See Video Abstract.
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来源期刊
CiteScore
4.50
自引率
7.70%
发文量
572
审稿时长
3-8 weeks
期刊介绍: Diseases of the Colon & Rectum (DCR) is the official journal of the American Society of Colon and Rectal Surgeons (ASCRS) dedicated to advancing the knowledge of intestinal disorders by providing a forum for communication amongst their members. The journal features timely editorials, original contributions and technical notes.
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