内視鏡頭による頭蓋骨底部手術後の便秘の発生率と再建的結果への影響

Theodore V Nguyen¹, Ellen M Hong¹, Benjamin F Bitner¹

¹Department of Otolaryngology - Head and Neck Surgery, University of California, Irvine, Orange, California, United States.

Journal of neurological surgery. Part B, Skull base

|September 2, 2025

まとめ

術後の便秘は,内視頭蓋骨基礎手術 (ESBS) の後に一般的であり,より長い回復とオピオイド使用に関連しています. ESBS患者のこの一般的な問題を管理するのに役立つかもしれません.

科学分野:

神経外科
胃腸内科
手術の結果

背景:

エンドスコープによる頭蓋骨底部手術 (ESBS) の後の便秘は,緊張を引き起こし,潜在的に頭蓋骨内圧の変化を引き起こし,外科的再建に影響を与える可能性があります.
便秘の流行と要因を理解することは患者の回復と再建の成功を最適化するために不可欠です

研究の目的:

術後の便秘の有病率を測定する.
ESBS の後に便秘に寄与する要因を特定する.
術後の便秘が再建に与える影響を評価する.

主な方法:

2018年7月から2022年12月の間にESBSを受けた213人の患者の遡及レビュー.
収集されたデータには,排便の頻度,手術の指示,患者の人口統計,BMI,慢性疼痛歴,ベッドレストの持続時間,滞在期間 (LOS) およびオピオイド鎮痛剤の使用が含まれています.
便秘は排便なしの48時間と定義され,排便や便の軟化剤などの介入が記録された.

主要な成果:

患者の69% (146/ 213) が手術後の便秘の高い罹患率を観察した.
便秘は,手術後のベッドレストと,手術後のモルヒネ等価量 (MED) の増加と有意に関連していました.
術後の便秘は独立して長期滞在 (LOS) を予測したが,脳脊髄液 (CSF) の漏れの増加と相関しなかった.

結論:

手術後の便秘の高率はESBSの後で発生し,おそらく不動化とオピオイド使用の影響を受けます.
便秘を和らげるため,ESBS患者では,立体便秘の実施を検討すべきである.
便秘を患った患者では,手術後のCSF漏れのリスクは増加しなかった.

キーワード:

CSFの漏れ鎮痛剤便秘オピオイド術後の状態頭蓋骨の基礎の再建の結果

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