经过修改的直肠门拉透解剖,以避免永久性口腔,并减少下方直肠瘤的术后并发症
Shinichiro Mori1, Kan Tanabe2, Masumi Wada2
1Department of Digestive Surgery, Breast and Thyroid Surgery, Graduate School of Medicine, Kagoshima University, Sakuragaoka 8-35-1, Kagoshima City, Kagoshima, 890-8520, Japan. aristo-di-morishin@nifty.com.
Surgical endoscopy
|June 13, 2023
概括
拉透超 (PTU) 与即时的直肠口腔解剖,显著降低了永久性静脉的发生率和关节保护超低前置切除后的并发症. 这种技术为寻求避免 ostomy 手术的患者提供了一个安全的替代方案.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 下直肠瘤往往需要进行关节保护手术,例如超低前置切除 (ULAR).
- 传统的ULAR可能需要永久性静脉栓塞或导致术后并发症.
- 拉透超 (PTU) 技术涉及即时的手工色腔解剖,以潜在地减轻这些问题.
研究的目的:
- 为了比较PTU与非PTU方法的临床结果,在关节保护ULAR后用于下直肠瘤.
- 评估两种技术之间永久性口腔瘤和整体术后并发症的发生率.
- 评估手术时间,静脉漏和住院时间.
主要方法:
- 一项追溯的队列研究,对100名接受关节保护ULAR治疗直肠瘤的患者进行.
- 患者被分为PTU (n=29) 和非PTU (n=71) 组.
- 评估了临床结果,包括静脉栓率,并发症,手术时间和住院时间.
主要成果:
- 与非PTU组相比,PTU组的永久性静脉瘤和整体并发症率明显较低 (P < 0.01).
- 在PTU组中,不需要永久性口腔.
- PTU导致综合住院时间显著缩短 (P < 0.01) 和第二阶段手术时间缩短 (P < 0.01).
- 两组之间,解剖漏和严重并发症 (Clavien-Dindo III级) 的发生率是可比的.
结论:
- 使用PTU技术进行即时的直肠解剖,是一种安全有效的替代方法,可以在下直肠瘤中保护缩管的ULAR.
- PTU显著减少了对永久性口腔的需要和整体的术后并发症.
- 这种方法为患者提供了一个可行的选择,目的是避免 ostomy 手术.
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