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首页> 外文期刊>Colorectal disease: the official journal of the Association of Coloproctology of Great Britain and Ireland >Study protocol evaluating the use of bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicenter randomized controlled trial
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Study protocol evaluating the use of bowel stimulation before loop ileostomy closure to reduce postoperative ileus: a multicenter randomized controlled trial

机译：研究方案评估肠stimula的使用起跳前循环回肠造口术关闭以减少posto餐馆perative肠梗阻:多中心随机controlled试验

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Abstract Aim Postoperative ileus is the most commonly observed morbidity following ileostomy closure. Studies have demonstrated that the defunctionalized bowel of a loop ileostomy undergoes a series of functional and structural changes, such as atrophy of the intestinal villi and muscular layers, which may contribute to ileus. A single‐centre study in Spain demonstrated that preoperative bowel stimulation via the distal limb of the loop ileostomy decreased postoperative ileus, length of stay and time to gastrointestinal function. Method A multicentre randomized controlled trial involving patients from Canadian institutions was designed to evaluate the effect of preoperative bowel stimulation before ileostomy closure on postoperative ileus. Stimulation will include canalizing the distal limb of the ileostomy loop with an 18Fr Foley catheter and infusing it with a solution of 500?ml of normal saline mixed with 30?g of a thickening agent (Nestle ? Thicken‐Up ? ). This will be performed 10 times over the 3?weeks before ileostomy closure in an outpatient clinic setting by a trained Enterostomal Therapy nurse. Surgeons and the treating surgical team will be blinded to their patient's group allocation. Data regarding patient demographics, and operative and postoperative variables, will be collected prospectively. Primary outcome will be postoperative ileus, defined as an intolerance to oral food in the absence of clinical or radiological signs of obstruction, that either requires nasogastric tube insertion or is associated with two of the following on or after post‐operative day 3: nausea/vomiting; abdominal distension; and the absence of flatus. Secondary outcomes will include length of stay, time to tolerating a regular diet, time to first passage of flatus or stool and overall morbidity. A cost analysis will be performed to compare the costs of conventional care with conventional care plus preoperative stimulation. Discussion This manuscript discusses the potential benefits of preoperative bowel stimulation in improving postoperative outcomes and outlines our protocol for the first multicenter study to evaluate preoperative bowel stimulation before ileostomy closure. The results of this study could have considerable implications for the care of patients undergoing ileostomy closure.
机译：抽象的目的术后肠梗阻是最发病率普遍观察到回肠造口术关闭。defunctionalized肠循环回肠造口术经历了一系列的功能和结构变化,如肠道绒毛萎缩和肌肉层,这可能导致肠梗阻。表明,术前肠道刺激通过循环的肢体远端回肠造口术减少术后肠梗阻,留下来的长度胃肠功能。多中心随机对照试验涉及病人从加拿大机构设计评估术前肠道的作用刺激在回肠造口术关闭术后肠梗阻。修改成运河回肠造口术的远端肢体循环与18 fr弗利导管,并注入一个解决方案的500 ?30？)。3 ?诊所设置由一个训练有素的Enterostomal疗法护士。将蒙蔽他们的病人的小组吗分配。手术和术后变量,将前瞻性地收集。术后肠梗阻,定义为杜绝口服食物缺乏临床或放射阻塞的迹象,需要鼻胃管插入或与两个以下或之后后必经的第三天:恶心/呕吐;膨胀;结果将包括住院时间、时间容忍一个常规饮食,首次通过时间肠胃胀气或粪便和总体发病率。将进行比较分析成本传统的护理与常规护理加术前刺激。手稿讨论的潜在好处术前肠道刺激在改善术后的结果,并概述了我们的协议第一多中心研究评估在回肠造口术术前肠道刺激关闭。相当大的影响的患者回肠造口术关闭。

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