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doi:10.22028/D291-35388
Titel: | Salvage surgery for continent ileostomies (CI) after a first successful revision: more long-term blame on the reservoir than the nipple valve |
VerfasserIn: | Ecker, Karl-Wilhelm Tönsmann, Mathias Ecker, Nils Karl Josef Möslein, Gabriela |
Sprache: | Englisch |
Titel: | International Journal of Colorectal Disease |
Verlag/Plattform: | Springer Nature |
Erscheinungsjahr: | 2021 |
Freie Schlagwörter: | Continent ileostomy (CI) Kock Pouch CI survival CI revisional surgery CI and underlying disease |
DDC-Sachgruppe: | 610 Medizin, Gesundheit |
Dokumenttyp: | Journalartikel / Zeitschriftenartikel |
Abstract: | Purpose The aim of the study was to investigate the underlying cause of long-term complications in patients requiring at least one revision surgery of a continent ileostomy (CI) and to analyze functional outcome. Methods Only patients with CI at least one revision were included in the retrospective data analysis. Four different classes of complications (Cl A–D) were defined: Cl A = Nipple valve (NV), Cl B = pouch, Cl C = outlet (stoma), and Cl D = afferent loop (AL). Associations between underlying disease and origin of complications were analyzed. Cumulative probabilities were calculated using Kaplan–Meier analysis. Results A total of 77 patients were identified with a follow-up of 30 years, requiring 133 surgeries for 148 complications (c.). Cl A 49 c. (33.1%), Cl B 50 c. (33.8%), Cl C 39 c. (26.4%), and Cl D 10 c. (6.8%). Cl A and C complications were not correlated to underlying disease, whereas Cl B and D complications were only found in ulcerative colitis (UC) and Crohn’s disease (CD). The cumulative probability of a second revision showed a linear rise, reaching 62.5% after 20 years. Cl A and B complications both reached 42.1%. Eleven (14.3%) patients (10 Cl B) had pouch failure in a follow-up period of 11.5 ± 8.7 years (1–31 years), whereas 66 (85.7%) had successful revisional surgery. Overall CI survival was 78.8% at 44 years. Conclusion CI survival is limited by inflammatory complications of the pouch based on the underlying disease and not by mechanical limitations of the NV. |
DOI der Erstveröffentlichung: | 10.1007/s00384-021-04054-x |
Link zu diesem Datensatz: | urn:nbn:de:bsz:291--ds-353887 hdl:20.500.11880/32306 http://dx.doi.org/10.22028/D291-35388 |
ISSN: | 1432-1262 0179-1958 |
Datum des Eintrags: | 3-Feb-2022 |
Fakultät: | M - Medizinische Fakultät |
Fachrichtung: | M - Chirurgie |
Professur: | M - Keiner Professur zugeordnet |
Sammlung: | SciDok - Der Wissenschaftsserver der Universität des Saarlandes |
Dateien zu diesem Datensatz:
Datei | Beschreibung | Größe | Format | |
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Ecker2021_Article_SalvageSurgeryForContinentIleo.pdf | 750,04 kB | Adobe PDF | Öffnen/Anzeigen |
Diese Ressource wurde unter folgender Copyright-Bestimmung veröffentlicht: Lizenz von Creative Commons