| 摘要 |
Objective: This study reviewed 15 years of experience with 94 patients to identify
an optimal feeding protocol and hospitalization plan for patients with imperforate
anus who underwent colostomy takedown.
Methods: The authors treated 145 patients with imperforate anus from June 1988
to August 2003. Among them, 94 underwent a 3-stage operation (colostomy,
posterior sagittal anorectoplasty, and colostomy takedown). Traditionally, patients
started feeding on the 2nd or 3rd postoperative day (POD) and went home on the 5th or
6th POD (n=10). In 1991, the authors adopted a protocol in which patients received
feeding on the 1st POD and were discharged on the 2nd POD (n=21). Then, in 1994, a
more aggressive protocol permitted feeding 6 hours after colostomy takedown.
However, one patient suffered an anastomotic leak, which subsided three days later
after abstinence from feeding. Thus the 1st POD feeding protocol was resumed in
1995 and 59 more patients were added to the 1991 program.
Results: Of the 80 patients following the 1991 protocol, feeding started at 20.2
hours (range 17.4-41.5), and the mean postoperative hospital stay was 1.9 days
(range 1.7-3.2). Three patients encountered minor complications but recovered after
conservative treatment. Of the 4 patients following the 1994 protocol, one suffered
anastomotic leakage.
Conclusion: Our 1st POD feeding and 2nd POD discharge plan is safe and efficient
for patients with imperforate anus who undergo colostomy takedown. |
