Early versus conventional stoma closure following bowel surgery: A randomized controlled trial.
Early versus conventional stoma closure following bowel surgery: A randomized controlled trial.
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DOI：
10.4103/sjg.sjg_445_17
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发表时间：
2018-01
期刊：
影响因子：
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通讯作者：
Kate V
中科院分区：
文献类型：
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作者：
Nelson T;Pranavi AR;Sureshkumar S;Sreenath GS;Kate V
在并发症发生率、健康相关生活质量（QoL）和住院时间（洛）方面，比较去功能性分流造口手术后早期造口闭合与传统造口闭合。本研究设计为前瞻性平行组随机对照试验。纳入了2014年2月至2015年11月期间在肠道手术后接受临时造口的患者。评估了早期和常规造口闭合后的并发症（内科和外科）发生率。还测量了健康相关的QoL和洛。入选患者100例，每组50例。术后并发症，包括腹腔造口（6% vs. 2%;P = 0.307），伤口感染（32% vs. 18%; P = 0.106）、腹腔内积液（14% vs. 18%; P = 0.585）、吻合口漏（4% vs. 8%;P = 0.400）和内科并发症相当（22% vs. 32%;P = 0.257）。两组的住院时间、总体死亡率和发病率（64% vs. 44%; P = 0.05）相似。在早期造口闭合组中，造口护理成本显著降低（96% vs. 2%; P = 0.001）。早期造口闭合组的患者生活质量也明显更好。早期造口闭合不会增加术后并发症的风险，降低造口护理的成本，并导致更好的生活质量。
To compare early stoma closure with conventional stoma closure following defunctioning diversion stoma surgery with respect to the frequency of complications, health-related quality of life (QoL), and length of hospitalization (LoH). This study was designed as a prospective parallel-arm randomized controlled trial. Patients who underwent temporary stoma following bowel surgery between February 2014 and November 2015 were included. The rate of complications (medical and surgical) following early and conventional stoma closure was assessed. Health-related QoL and LoH were also measured. One hundred patients were included, with 50 cases in each group. Postoperative complications including laparostoma (6% vs. 2%;P = 0.307), wound infection (32% vs. 18%; P = 0.106), intra-abdominal collection (14% vs. 18%; P = 0.585), anastomotic leak (4%vs. 8%;P = 0.400), and medical complications were comparable (22% vs. 32%;P = 0.257). The length of hospital stay, overall mortality and morbidity (64% vs. 44%; P = 0.05) were similar across the two groups. There was a significant reduction in the cost towards stoma care (96% vs. 2%; P = 0.001) in the early stoma closure group. Patients in the early stoma closure group also had a significantly better QoL. Early stoma closure does not carry an increased risk of postoperative complications, reduces cost towards stoma care, and leads to better a QoL.