结肠直肠切除后的非计划性手术:指针手术中的腹腔镜是预防死亡的保护因素
Diane Mege1, Charles Sabbagh2, Alain Deleuze3
1Aix Marseille Univ, APHM, Department of Digestive Surgery, Timone University Hospital, 264 Rue Saint-Pierre, 13005, Marseille, France. dr.dianemege@gmail.com.
Surgical endoscopy
|July 3, 2023
概括
结直肠切除后的无计划手术后的死亡率影响10%的患者. 高龄,较高的ASA分数,开放式手术方法和延迟治疗是导致死亡的关键风险因素.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 患者死亡率 患者死亡率
背景情况:
- 结直肠切除后的非计划性手术带来了重大风险.
- 识别死亡风险因素对于改善患者的治疗结果至关重要.
研究的目的:
- 评估结肠直肠切除后无计划手术后死亡的风险因素.
- 确定术后死亡率的独立预测因素.
主要方法:
- 法国国家队列接受结直肠切除 (2011-2020) 的患者的回顾性分析.
- 包括指数手术和非计划手术特征的术后数据.
- 多变量分析以确定死亡率的独立预测因素.
主要成果:
- 在547名患者中,10%的患者在未计划的手术后死亡.
- 死亡率的独立预测因素包括年龄较大,美国麻醉学会 (ASA) 较高的得分 (3-4),指数手术的开放方法和延迟管理.
- 在指针手术期间的 laparoscopic 方法与更好的预后有关.
结论:
- 在非计划性手术后,结肠直肠切除后的死亡率是显著的 (10%).
- 确定的主要危险因素是晚年,虚弱 (ASA分数3-4),开放指数手术和延迟治疗.
- 在需要随后的无计划手术的情况下,像腹腔镜术这样的最小侵入性方法可能会改善结果.
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