从腹腔镜切除术转换为开放尾切除术的危险因素
Bruno Leonardo Bancke Laverde1, Matthias Maak1, Melanie Langheinrich2
1Department of General and Visceral Surgery, Friedrich-Alexander-University, Krankenhausstraße 12, 91054 Erlangen, Germany.
Journal of clinical medicine
|July 14, 2023
概括
腹腔镜尾切除术是尾炎的标准,但转换为开放手术发生在5.5%的病例中. 术内发现,而不仅仅是炎症标志物,预测需要转换和增加患者的发病率.
科学领域:
- 手术方面的创新.
- 胃肠道手术 胃肠道手术
- 最少侵入性手术是最少侵入性的手术.
背景情况:
- 腹腔镜尾切除术是急性尾炎的标准手术治疗方法.
- 转换为开放性手术有时是必要的.
- 确定转化预测因素对于患者管理至关重要.
研究的目的:
- 确定与从腹腔镜切除术转换为开放尾切除术相关的风险因素.
- 分析转化对患者发病率的影响.
主要方法:
- 对1220名成年患者进行急性尾炎的腹腔镜尾切除术 (2010-2020年) 的回顾性分析.
- 与转换和没有转换的患者之间的术前,术后和术后数据的比较.
- 统计分析以确定独立的风险因素和结果.
主要成果:
- 转换率为5.5%的时间.
- 转换的独立风险因素包括手术前较高的白细胞 (WBC) 计数,C反应蛋白 (CRP) 水平,以及手术后的发现,如穿孔,瘤,,,腹膜炎.
- 转换独立地与术后发病率的增加有关.
结论:
- 腹腔镜尾切除术对于大多数急性尾炎病例来说是安全的和可行的.
- 手术前的炎症标志物对转化具有有限的预测价值.
- 术内发现对于决定转换至关重要.
- 需要转换的患者需要更密切的术后监测,因为并发症风险更高.
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