消化管切除术前胃缺血条件的影响:系统性审查和元分析
Alberto Aiolfi1, Davide Bona2, Gianluca Bonitta2
1I.R.C.C.S. Ospedale Galeazzi-Sant'Ambrogio, Division of General Surgery, Department of Biomedical Science for Health, University of Milan, Via C. Belgioioso, 173, 20157, Milan, Italy. alberto.aiolfi86@gmail.com.
在食道切除术前的胃缺血条件 (GIC) 显著降低了解静脉泄漏和狭窄的风险. 这一元分析表明,GIC是改善食道切除术后手术结果的有希望的策略.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 医疗器械 医疗器械
背景情况:
- 肠道并发症,特别是与缺血相关的并发症,在食道切除术后是一个重大挑战.
- 胃缺血条件 (GIC) 已成为减轻这些风险的潜在策略.
- 评估GIC在减少短期门并发症方面的疗效对于患者的治疗结果至关重要.
研究的目的:
- 系统地评估GIC对食道切除术后的门并发症的影响.
- 为了比较经过GIC和未经GIC治疗的患者之间道泄漏 (AL),道狭窄 (AS) 和胃管缩 (GCN) 的发生率.
- 评估其他短期结果,包括术后肺炎,整体并发症,手术时间,住院时间和30天死亡率.
主要方法:
- 在Scopus,Web of Science,MEDLINE和PubMed进行了全面的文献搜索,截至2023年3月31日.
- 一项元分析包括14项涉及1760名接受食道切除术的患者的研究,比较GIC (732名患者) 与没有GIC (1028名患者).
- 主要结局包括AL,AS和GCN,使用风险比率 (RR) 和95%信心区间 (95%CI) 进行分析.
主要成果:
- GIC与显著降低了道漏洞 (RR = 0.63; p < 0.01) 和道狭窄 (RR = 0.51; p = 0.02) 的风险有关.
- 两组之间胃管死结的风险没有显著差异 (RR = 0.56; p = 0.28).
- 术后肺炎,整体并发症,手术时间,住院时间和30天死亡率没有显著差异.
结论:
- 在食道切除术之前的胃缺血条件似乎与减少道泄漏和狭窄的风险有关.
- 需要进一步的研究来确定GIC的最佳患者子集,技术和时间.
- GIC提出了一种潜在的有益策略,以提高食道切除患者的手术安全性.
更多相关视频
06:25Cooling or Warming the Esophagus to Reduce Esophageal Injury During Left Atrial Ablation in the Treatment of Atrial Fibrillation
Published on: March 15, 2020
03:32Single Incision Plus One Port Laparoscopic Proximal Gastrectomy with Double Channel Anastomosis for Gastric Cancer Treatment
Published on: December 27, 2024
相关概念视频
Peptic Ulcer Disease V: Surgical Management and Nursing Care
Surgical Interventions for Peptic Ulcer Disease
Esophageal Varices-I: Introduction
Gastroesophageal Reflux Disease II: Clinical Features and Management
Clinical Manifestations
GERD presents itself in a multitude of ways, with symptoms varying from person to person. The hallmark symptoms are...
Esophageal Strictures-I: Introduction
Etiology
The primary cause of esophageal strictures is long-standing gastroesophageal reflux disease (GERD), accounting for about 70 to 80% of adult cases. Chronic acid reflux can lead to injury and scarring of the esophageal lining, culminating in...
Endoscopic Procedures I: Esophagogastroduodenoscopy
During an EGD, the endoscope can be used to:
Esophageal Perforation-II: Clinical Manifestations and Management
Clinical Manifestations:
