切换至 "中华医学电子期刊资源库"

中华疝和腹壁外科杂志(电子版) ›› 2025, Vol. 19 ›› Issue (05) : 571 -576. doi: 10.3877/cma.j.issn.1674-392X.2025.05.017

所属专题: 文献

综述

回肠造口对患者潜在影响的研究进展
王子聪1,2, 武永胜3,()   
  1. 1010059 呼和浩特,内蒙古医科大学
    2056001 河北,邯郸市中心医院泌尿外科
    3010020 呼和浩特,北京大学肿瘤医院内蒙古医院(内蒙古医科大学附属肿瘤医院)胃肠肿瘤外科
  • 收稿日期:2024-05-09 出版日期:2025-10-18
  • 通信作者: 武永胜
  • 基金资助:
    内蒙古自治区卫生健康科技计划项目(202202219)

Potential effects and research progress of ileostomy on the body of patients

Zicong Wang1,2, Yongsheng Wu3,()   

  1. 1Inner Mongolia Medical University, Hohhot 010059, China
    2Urology Surgery, Handan Central Hospital, Handan 056001, Hebei Province, China
    3Department of Gastrointestinal Cancer Surgery, Peking University Cancer Hospital (Inner Mongolia Campus), Affiliated Cancer Hospital of Inner Mongolia Medical University, Hohhot 010020, China
  • Received:2024-05-09 Published:2025-10-18
  • Corresponding author: Yongsheng Wu
引用本文:

王子聪, 武永胜. 回肠造口对患者潜在影响的研究进展[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(05): 571-576.

Zicong Wang, Yongsheng Wu. Potential effects and research progress of ileostomy on the body of patients[J/OL]. Chinese Journal of Hernia and Abdominal Wall Surgery(Electronic Edition), 2025, 19(05): 571-576.

回肠造口术是腹部外科中一种较为普遍的手术,适用于治疗多种消化道疾病。在临床实践中,该手术具有重要的治疗意义。虽然回肠造口的一些常见并发症已广为熟知,但一些潜在的影响尚未引起足够的重视,可能对患者的生活质量产生重要的影响。因此,目前关于是否普及该手术仍存在一些争议。本文综述了回肠造口术对机体相关脏器功能、肠道微生物、电解质等病理生理功能以及造口患者社会心理方面的影响研究现状。以期对广大医护人员和科研工作者有一定的借鉴作用。

Ileostomy is a common operation in abdominal surgery, which is suitable for the treatment of various digestive diseases. In clinical practice, this operation has important therapeutic significance. Although some of the common complications of ileostomy are well known, some potential effects have not received enough attention and may have an important impact on patients' lives. Therefore, there is still some controversy about whether the procedure should be popularized. In this paper, the effects of ileostomy on the pathophysiological functions of related organs, intestinal microbes, electrolytes, and the social and psychological aspects of patients with stomas were reviewed. In order to have some reference for the majority of medical staff and scientific research workers.

[1]
Sier MF, Wisselink DD, Ubbink DT, et al. Randomized clinical trial of intracutaneously versus transcutaneously sutured ileostomy to prevent stoma-related complications(ISI trial)[J]. Br J Surg, 2018, 105(6): 637-644.
[2]
Coco C, Tondolo V, Amodio LE, et al. Role and morbidity of protective ileostomy after anterior resection for rectal cancer: one centre experience and review of literature[J]. J Clin Med, 2023, 12(23): 7229.
[3]
Murken DR, Bleier JIS. Ostomy-related complications[J]. Clin Colon Rectal Surg, 2019, 32(3): 176-182.
[4]
Loria A, Melucci A, Speranza J, et al. Acute kidney injury is a common and significant complication following ileostomy formation[J]. Colorectal Dis, 2022, 24(1): 102-110.
[5]
Smith SA, Ronksley PE, Tan Z, et al. New ileostomy formation and subsequent community-onset acute and chronic kidney disease: a population-based cohort study[J]. Ann Surg, 2021, 274(2): 352-358.
[6]
Yaegashi M, Otsuka K, Kimura T, et al. Early renal dysfunction after temporary ileostomy construction[J]. Surg Today, 2020, 50(7): 703-710.
[7]
Rutegård M, Häggström J, Back E, et al. Defunctioning loop ileostomy in anterior resection for rectal cancer and subsequent renal failure: nationwide population-based study[J]. BJS Open, 2023, 7(3): zrad010.
[8]
Bluth EI, Merritt CR, Sullivan MA, et al. Inflammatory bowel disease and cholelithiasis: the association in patients with an ileostomy[J]. South Med J, 1984, 77(6): 690-692.
[9]
Wieck MM, Schlieve CR, Thornton ME, et al. Prolonged absence of mechanoluminal stimulation in human intestine alters the transcriptome and intestinal stem cell niche[J]. Cell Mol Gastroenterol Hepatol, 2017, 3(3): 367-388. e1.
[10]
Christl SU, Scheppach W. Metabolic consequences of total colectomy[J]. Scand J Gastroenterol Suppl, 1997, 222: 20-24.
[11]
Crane J, Ari K, Lam S, et al. Perforated gallbladder in a parastomal hernia[J]. BMJ Case Rep, 2021, 14(6): e240030.
[12]
Kurchin A, Ray JE, Bluth EI, et al. Cholelithiasis in ileostomy patients[J]. Dis Colon Rectum, 1984, 27(9): 585-588.
[13]
Chong Vh. Iatrogenic biliary stone[J]. Surg Technol Int, 2005, 14: 147-55.
[14]
Mulliri A, Menahem B, Alves A, et al. Ursodeoxycholic acid for the prevention of gallstones and subsequent cholecystectomy after bariatric surgery: a meta-analysis of randomized controlled trials[J]. J Gastroenterol, 2022, 57(8): 529-539.
[15]
Gupta S, Wu X, Moore T, et al. frequency, risk factors, and adverse sequelae of bone loss in patients with ostomy for inflammatory bowel diseases[J]. Inflamm Bowel Dis, 2014, 20(2): 259-264.
[16]
Ng DH, Pither CA, Wootton SA, et al. The 'not so short-bowel syndrome': potential health problems in patients with an ileostomy[J]. Colorectal Dis, 2013, 15(9): 1154-1161.
[17]
You K, Yang L, Shen J, et al. Relationship between gut microbiota and bone health[J]. Mini Rev Med Chem, 2022, 22(18): 2406-2418.
[18]
d'Amelio P, Sassi F. Gut microbiota, immune system, and bone[J]. Calcif Tissue Int, 2018, 102(4): 415-425.
[19]
Bosaily A, Edminister J, Magal S, et al. Extensive circumferential heterotopic ossification discovered at the base of a loop ileostomy[J]. Case Rep Surg, 2019, 2019: 4036716.
[20]
Billington EO, Mahajan A, Benham JL, et al. Effects of probiotics on bone mineral density and bone turnover: a systematic review[J]. Crit Rev Food Sci Nutr, 2023, 63(19): 4141-4152.
[21]
He W, Bertram HC, Yin JY, et al. Lactobacilli and their fermented foods as a promising strategy for enhancing bone mineral density: a review[J]. J Agric Food Chem, 2024, 72(32): 17730-17745.
[22]
Hanson WR. Proliferative and morphological adaptation of the intestine to experimental resection[J]. Scand J Gastroenterol Suppl, 1982, 74: 11-20.
[23]
Józsa T, Magyar A, Cserni T, et al. Short-term adaptation of rat intestine to ileostomy: implication for pediatric practice[J]. J Invest Surg, 2009, 22(4): 292-300.
[24]
Uga N, Nakatani M, Yoshimura A, et al. A new murine ileostomy model: recycling stool prevents intestinal atrophy in the distal side of ileostomy[J]. Fujita Med J, 2021, 7(2): 41-49.
[25]
Aksakal G, Ng S, An V. An unusual case of caecal perforation following ileostomy reversal[J]. BMJ Case Rep, 2019, 12(8): e229961.
[26]
Garfinkle R, Savage P, Boutros M, et al. Incidence and predictors of postoperative ileus after loop ileostomy closure: a systematic review and meta-analysis[J]. Surg Endosc, 2019, 33(8): 2430-2443.
[27]
Buscail E, Planchamp T, Le Cosquer G, et al. Postoperative ileus after digestive surgery: network meta-analysis of pharmacological intervention[J]. Br J Clin Pharmacol, 2024, 90(1): 107-126.
[28]
d'Ambrosio F, Pappalardo C, Scardigno A, et al. Peristomal skin complications in ileostomy and colostomy patients: what we need to know from a public health perspective[J]. Int J Environ Res Public Health, 2022, 20(1): 79.
[29]
Rippon M, Perrin A, Darwood R, et al. The potential benefits of using aloe vera in stoma patient skin care[J]. Br J Nurs, 2017, 26(5): s12-s19.
[30]
Mongelard K, Mynster T, Jensen KK. Stoma-site hernia after stoma reversal following rectal cancer resection[J]. Dan Med J, 2020, 67(3): A06190353.
[31]
许彬彬,周林秋,段建春,等. 预防性补片置入在预防造口旁疝中应用价值的meta分析[J]. 中国普通外科杂志, 2021, 30(4): 386-398.
[32]
Lu D, Zinn R, Mitchell C, et al. Malignant transformation of an ileostomy stoma scar: an unusual presentation[J]. Anz J Surg, 2020, 90(9): 1770-1772.
[33]
Ameer A, Mirza MB, Talat N. The outcome of purse-string versus conventional wound closure techniques in patients undergoing stoma reversal: a randomized controlled trial[J]. J Pediatr Surg, 2024, 59(6): 1186-1189.
[34]
邰奕,姜武,卢震海. 造口回纳围手术期管理及手术时机选择[J]. 结直肠肛门外科, 2019, 25(2): 127-130, 146.
[35]
Aurigemma NC, Koltun KJ, Vanevery H, et al. Linking the gut microbiota to bone health in anorexia nervosa[J]. Curr Osteoporos Rep, 2018, 16(1): 65-75.
[36]
Yilmaz B, Fuhrer T, Morgenthaler D, et al. Plasticity of the adult human small intestinal stoma microbiota[J]. Cell Host Microbe, 2022, 30(12): 1773-1787. e6.
[37]
Beamish EL, Johnson J, Shaw EJ, et al. Loop ileostomy-mediated fecal stream diversion is associated with microbial dysbiosis[J]. Gut Microbes, 2017, 8(5): 467-478.
[38]
Beamish EL, Johnson J, Shih B, et al. Delay in loop ileostomy reversal surgery does not impact upon post-operative clinical outcomes. Domplications are associated with an increased loss of microflora in the defunctioned intestine[J]. Gut Microbes, 2023, 15(1): 2199659.
[39]
Miyata M, Yamakawa H, Hamatsu M, et al. Enterobacteria modulate intestinal bile acid transport and homeostasis through apical sodium-dependent bile acid transporter(SLC10A2) expression[J]. J Pharmacol Exp Ther, 2011, 336(1): 188-196.
[40]
Feng HY, Chen YC. Role of bile acids in carcinogenesis of pancreatic cancer: an old topic with new perspective[J]. World J Gastroenterol, 2016, 22(33): 7463-7477.
[41]
Lee SY, Park HM, Kim CH, et al. Dysbiosis of gut microbiota during fecal stream diversion in patients with colorectal cancer[J]. Gut Pathog, 2023, 15(1): 40.
[42]
Ma H, Li X, Yang H, et al. The pathology and physiology of ileostomy[J]. Front Nutr, 2022, 9: 842198.
[43]
Rowe KM, Schiller LR. Ileostomy diarrhea: pathophysiology and management[J]. Proc(Bayl Univ Med Cent), 2020, 33(2): 218-226.
[44]
Messaris E, Sehgal R, Deiling S, et al. Dehydration is the most common indication for readmission after diverting ileostomy creation[J]. Dis Colon Rectum, 2012, 55(2): 175-180.
[45]
Sharma V, Cheema P, Kaushik R, et al. Hypocalcaemia-a rare complication of ileostomy[J]. Trop Doct, 2022, 52(2): 337-338.
[46]
Rud CL, Brantlov S, Quist JR, et al. sodium depletion and secondary hyperaldosteronism in outpatients with an ileostomy: a cross- sectional study[J]. Scand J Gastroenterol, 2023, 58(9): 971-979.
[47]
Michońska I, Polak-Szczybyło E, Sokal A, et al. Nutritional issues faced by patients with intestinal stoma: a narrative review[J]. J Clin Med, 2023, 12(2): 510.
[48]
Arenas Villafranca JJ, López-Rodríguez C, Abilés J, et al. Protocol for the detection and nutritional management of high-output stomas[J]. Nutr J, 2015, 14: 45.
[49]
De Oliveira AL, Boroni Moreira AP, Pereira Netto M, et al. A cross-sectional study of nutritional status, diet, and dietary restrictions among persons with an ileostomy or colostomy[J]. Ostomy Wound Manage, 2018, 64(5): 18-29.
[50]
Migdanis A, Koukoulis G, Mamaloudis I, et al. The effect of a diverting ileostomy formation on nutritional status and energy intake of patients undergoing colorectal surgery[J]. Clin Nutr Espen, 2020, 40: 357-62.
[51]
Vasilopoulos G, Makrigianni P, Polikandrioti M, et al. Pre- and post-operative nutrition assessment in patients with colon cancer undergoing ileostomy[J]. Int J Environ Res Public Health, 2020, 17(17): 6124.
[52]
Mitchell A, England C, Perry R, et al. Dietary management for people with an ileostomy: a scoping review[J]. JBI Evid Synth, 2021, 19(9): 2188-2306.
[53]
Karabulut HK, Dinç l, Karadag A. effects of planned group interactions on the social adaptation of individuals with an intestinal stoma: a quantitative study[J]. J Clin Nurs, 2014, 23(19-20): 2800-2813.
[54]
Borwell B. Continuity of care for the stoma patient: psychological considerations[J]. Br J Community Nurs, 2009, 14(8): 326, 328, 330-321.
[55]
Zou Y, Yang Q, Guan B, et al. Survey on mental health status and quality of life and correlation among patients with permanent stoma of colorectal tumor[J]. Comput Math Methods Med, 2022, 2022: 5792312.
[56]
Blackwell J, Saxena S, Jayasooriya N, et al. Stoma formation in crohn's disease and the likelihood of antidepressant use: a population-based cohort study[J]. Clin Gastroenterol Hepatol, 2022, 20(4): e703-e710.
[57]
Wang Y, Li S, Gong J, et al. Perceived stigma and self-efficacy of patients with inflammatory bowel disease-related stoma in china: a cross-sectional study[J]. Front Med(Lausanne), 2022, 9: 813367.
[1] 戴璐璐, 潘金花, 孔余霞, 蒋天安. 甲状腺微小乳头状癌射频消融与外科手术治疗效果的多角度对比[J/OL]. 中华医学超声杂志(电子版), 2025, 22(05): 444-450.
[2] 严征远, 张恒, 曹能琦, 方兴超, 陈大敏. 单孔+1腹腔镜结直肠癌根治切除术的有效性及安全性临床观察[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(06): 615-618.
[3] 肖燕玲, 杜升兰, 杨春梅, 许政文, 王玫. 正中切口在腹腔镜直肠癌根治术预防性回肠造口中的应用[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(05): 539-542.
[4] 杨春燕, 周晓苹. 机器人辅助技术在腹腔镜结直肠癌根治术中的研究进展[J/OL]. 中华普外科手术学杂志(电子版), 2025, 19(05): 584-588.
[5] 陈佳威, 杨松, 陆瑶, 张剑. 基底膜生物疝修补补片防治空盆腔综合征的有效性和安全性[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(05): 498-504.
[6] 周金玲, 张金伟, 曹迎九, 叶佳. 电刺激生物反馈联合凯格尔运动对Ⅱ~Ⅲ度子宫脱垂患者术后康复的影响[J/OL]. 中华疝和腹壁外科杂志(电子版), 2025, 19(05): 552-558.
[7] 郑文涛, 肖静, 欧阳兵, 吴毅, 廖开友, 李春林. 载药微球CalliSpheres经支气管动脉化疗栓塞术治疗Ⅲ~Ⅳ期非小细胞肺癌疗效分析[J/OL]. 中华肺部疾病杂志(电子版), 2025, 18(05): 691-696.
[8] 郑哲宇, 张磊, 张大伟, 潘卫东, 黄晓明. 全腹腔镜下ALPPS治疗结直肠癌肝转移的安全性和疗效[J/OL]. 中华肝脏外科手术学电子杂志, 2025, 14(05): 748-753.
[9] 关旭, 杨明. 中国微创手术的光辉历程与经自然腔道取标本手术的革新之路[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 385-388.
[10] 中国医师协会外科医师分会, 中华医学会外科分会胃肠外科学组, 中华医学会外科分会结直肠外科学组, 中国抗癌协会大肠癌专业委员会, 中国医师协会结直肠肿瘤专业委员会, 中国临床肿瘤学会结直肠癌专家委员会, 中国医师协会外科医师分会结直肠外科医师委员会, 中国医师协会肛肠医师分会肿瘤转移委员会, 中华医学会肿瘤学分会结直肠肿瘤学组, 中国医疗保健国际交流促进会转移肿瘤治疗学分会, 中国医疗保健国际交流促进会结直肠病分会. 结直肠癌肝转移诊断和综合治疗指南(V 2025)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 398-411.
[11] 中国抗癌协会NOSES专业委员会, 中国抗癌协会大肠癌专业委员会. 肿瘤整合诊治技术指南·NOSES技术(结直肠癌部分)[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 412-416.
[12] 赵南, 张明凯, Bhargava Divija, 赵世光, 张大明. 结直肠癌脑转移的临床特征与治疗策略进展[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 427-435.
[13] 鲁莽, 马晓璐, 沈浮, 王颢, 邵成伟, 张卫, 陆建平, 陆海迪. 基于磁共振的深度学习重建方法在直肠癌术前评估中的应用研究[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 445-456.
[14] 张娴, 王彬瞻, 王馨媛, 罗再, 王庆国, 程云章, 黄陈. 基于增强CT的二维、三维影像组学和联合模型对术前预测结直肠癌脉管侵犯价值研究[J/OL]. 中华结直肠疾病电子杂志, 2025, 14(05): 457-467.
[15] 王美, 赵勇, 张健, 张俐娜, 丁健华, 曹煜. 基于CT测量肾周脂肪面积对Lap-ISR吻合口并发症的预测价值[J/OL]. 中华临床医师杂志(电子版), 2025, 19(05): 367-373.
阅读次数
全文


摘要


AI


AI小编
你好!我是《中华医学电子期刊资源库》AI小编,有什么可以帮您的吗?