早期预防性回肠造口还纳的疗效分析及影响因素OA

Objective To explore the safety and feasibility of early preventive ileostomy return and in-fluencing factors.Methods The clinical medical record data of the patients with ileostomy return in this hos-pital from January 2019 to January 2023 were collected.The patients were divided into the early stage group(＜3 months,54 cases)and common group(＞3 months,140 cases)according to the time of ileostomy return.The general data,postoperative recovery and complications in the two groups were analyzed;the related fac-tors affecting early return decision-making were analyzed.Results There were no statistically significant differences in the gender,preoperative comorbidities,neoadjuvant chemoradiotherapy,tumor location,number of defecations after ileostomy closure,incidence rates of abdominal distension and complications between the early stage group and common group(P＞0.05);the differences in the age,stomal related complications,sto-ma living time,postoperative chemoradiotherapy and tumor stage between the two groups were statistically significant(P＜0.05);the duration of hospital stay,postoperative exhausting time and postoperative defeca-tion time in the early group were earlier than those in the common group(P＜0.05),and the incidence rate of anal bulge was higher than that in the common group(P＜0.05).The multivariate analysis showed that the age(OR=0.836,95％CI 0.791-0.883,P=0.000)and tumor location(OR=3.000,95％CI 1.139-7.899,P=0.026)were the main factors influencing the early ileostomy return.Conclusion Early preventive ileosto-my return is safe and feasible in young and middle-aged patients with median or high rectal tumor and could significantly improve the quality of life in the patients with stomal complications.