Stapled versus sutured closure of loop ileostomy: a randomized controlled trial.
| Autor: | Hasegawa H; University of Department of Surgery, Queen Elizabeth Hospital, Edgbaston, Birmingham, United Kingdom., Radley S, Morton DG, Keighley MR |
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| Jazyk: | angličtina |
| Zdroj: | Annals of surgery [Ann Surg] 2000 Feb; Vol. 231 (2), pp. 202-4. |
| DOI: | 10.1097/00000658-200002000-00008 |
| Abstrakt: | Objective: To compare the outcome after conventional sutured loop ileostomy closure with stapled ileostomy closure. Summary Background Data: A defunctioning loop ileostomy is now widely used in colorectal surgery. Subsequent closure may be associated with early complications, particularly bowel obstruction. The results of a preliminary nonrandomized study suggested that there was no significant difference in the rate of complications between sutured and stapled closure of loop ileostomy. Methods: One hundred forty-one consecutive patients who underwent loop ileostomy between 1993 and 1998 were randomized before surgery to either sutured or stapled loop ileostomy closure. Seventy-one patients had stapled closure and 70 had sutured closure. Results: Both groups were comparable in terms of age, sex, original operation, duration after original operation, and level of operating surgeon. Postoperative bowel obstruction occurred in 10/70 (14%) patients after sutured closure compared with 2/71 (3%) patients after stapled closure. Subgroup analysis of ileostomy closure in patients having an ileal pouch showed no significant difference in bowel obstruction between stapled and sutured closure (2/30 vs. 7/29). The incidence of other complications, readmissions, and reoperations did not differ between the two groups. The stapled closure was only 4 minutes quicker than sutured closure. The mean total hospital stay tended to be shorter after the stapled closure than the sutured closure, but this did not reach statistical significance. Conclusions: Bowel obstruction occurred less frequently after stapled closure, but the mean hospital stay and readmission and reoperation rate did not significantly differ between the two groups. |
| Databáze: | MEDLINE |
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