Bishop-Koop 手术与分离造口在新生儿胎粪性肠梗阻、先天性肠闭锁和坏死性小肠结肠炎中的效果比较,Medicine

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Bishop-Koop 手术与分离造口在新生儿胎粪性肠梗阻、先天性肠闭锁和坏死性小肠结肠炎中的效果比较
Medicine ( IF 1.3 ) Pub Date : 2019-07-01 , DOI: 10.1097/md.0000000000016304
Illya Martynov _{1,

2} , Jochen Raedecke ₂ , Jessica Klima-Frysch ₂ , Wolfram Kluwe ₂ , Joachim Schoenberger ₂

Affiliation

摘要旨在确定 Bishop-Koop 手术 (BK) 与开裂造口 (DS) 在新生儿胎粪性肠梗阻 (MI)、先天性肠闭锁 (CIA) 和坏死性小肠结肠炎 (NEC) 中的潜在价值和适用性。对 2000 年至 2019 年因 MI、CIA 和 NEC 经历 BK 和 DS 形成和闭合的新生儿进行了回顾性数据收集。分析了两种手术后的造口相关并发症。一百二名连续患者接受 BK (n = 57, 55.8%) 和 DS (n = 45, 44.2%) 治疗 MI (n = 38, 37.2%)、CIA (n = 31, 30.5%) 和 NEC (n = 33, 32.3%) 进行了分析。BK 组和 DS 组之间造口术的平均手术时间没有显着差异（156 ± 54 对 135 ± 66.8 分钟，P = .08）。BK 和 DS 形成后造口相关并发症的发生率分别为 8.7% 和 31.1%，分别（P = .005）。BK 和 DS 闭合后的并发症发生率分别为 3.5% 和 6.7% (P = .65)。BK 组造口逆转的手术时间和造口关闭后的住院时间明显缩短（82.2 ± 51.4 vs 183 ± 84.5 min 和 5.5 ± 2.7 vs 11.3 ± 3.9 天，P < .001）。BK 手术是一种安全、可靠、适用的新生儿手术技术，与 DS 造口相比，造口后并发症发生率低，造口闭合后手术时间和住院时间更短。外科医生应该将这种技术作为替代方法保留在他们的技能中。BK 组造口逆转的手术时间和造口关闭后的住院时间明显缩短（82.2 ± 51.4 vs 183 ± 84.5 min 和 5.5 ± 2.7 vs 11.3 ± 3.9 天，P < .001）。BK 手术是一种安全、可靠、适用的新生儿手术技术，与 DS 造口相比，造口后并发症发生率低，造口闭合后手术时间和住院时间更短。外科医生应该将这种技术作为替代方法保留在他们的技能中。BK 组造口逆转的手术时间和造口关闭后的住院时间明显缩短（82.2 ± 51.4 vs 183 ± 84.5 min 和 5.5 ± 2.7 vs 11.3 ± 3.9 天，P < .001）。BK 手术是一种安全、可靠、适用的新生儿手术技术，与 DS 造口相比，造口后并发症发生率低，造口闭合后手术时间和住院时间更短。外科医生应该将这种技术作为替代方法保留在他们的技能中。

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The outcome of Bishop-Koop procedure compared to divided stoma in neonates with meconium ileus, congenital intestinal atresia and necrotizing enterocolitis

Abstract To determine the potential value and suitability of Bishop-Koop procedure (BK) compared to divided stoma (DS) in neonates with meconium ileus (MI), congenital intestinal atresia (CIA), and necrotizing enterocolitis (NEC). A retrospective data collection from 2000 to 2019 on neonates undergoing BK and DS formation and closure for MI, CIA, and NEC was conducted. Ostomy related complications following both procedures were analyzed. One hundred two consecutive patients managed with a BK (n = 57, 55.8%) and DS (n = 45, 44.2%) for MI (n = 38, 37.2%), CIA (n = 31, 30.5%), and NEC (n = 33, 32.3%) were analyzed. Mean operating time for ostomy creation did not differ significantly between BK and DS groups (156 ± 54 vs 135 ± 66.8 min, P = .08). The prevalence of stoma-related complications following BK and DS formation was 8.7% and 31.1%, respectively (P = .005). The complication rate after BK and DS closure was 3.5% and 6.7%, respectively (P = .65). The operating time for ostomy reversal and length of hospital stay after stoma closure were significantly shorter in BK group (82.2 ± 51.4 vs 183 ± 84.5 min and 5.5 ± 2.7 vs 11.3 ± 3.9 days, P < .001). BK procedure is safe, reliable, and suitable technique in neonatal surgery with low complications rate following ostomy creation as well as shorter operating time and length of hospital stay after ostomy closure compared to DS ostomies. Surgeons should keep this technique as an alternative approach in their repertoire.

更新日期：2019-07-01

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