在肝移植期间,在复杂的腹部中暂时关闭腹部的长期随访
Jenna N Whitrock1, Ryan C Chae2, Alexandra B Kinzer2
1Cincinnati Research in Outcomes and Safety in Surgery Research Group, Department of Surgery, University of Cincinnati College of Medicine, OH. Electronic address: http://www.twitter.com/JennaWhitrockMD.
Surgery
|August 15, 2023
概括
暂时腹关闭 (TAC) 是复杂患者肝移植的安全选择,显示与初级关闭相似的长期存活率. 结果表明,当初级关闭具有挑战性时,TAC是可行的.
科学领域:
- 腹部外科手术 腹部外科手术
- 移植手术 移植手术
- 胃肠病学 胃肠病学
背景情况:
- 暂时腹关闭 (TAC) 经常用于肝移植患者具有具有挑战性的初级带关闭.
- 关于与肝移植中TAC相关的长期生存和患者结果的数据有限.
研究的目的:
- 评估肝移植中暂时腹部关闭的长期存活率和患者结局,与肝移植中初级带关闭相比.
- 为了比较两个关闭方法之间的患者特征和移植后并发症.
主要方法:
- 从2013年1月到2017年12月的肝移植患者的回顾性审查,随访5年.
- 患者根据他们是否经历了临时腹部关闭或立即初级带关闭而被分类.
主要成果:
- 需要TAC的患者手术前MELD得分和透析率较高,并且在90天内住院的可能性更高.
- 虽然1年生存率有差异 (82.7%的TAC vs. 90.9%的初级关闭),但5年生存率没有显著差异 (76.0% vs. 83.7%).
- TAC患者的住院时间更长,再入院率更高,并且不太可能被送回家.
结论:
- 肝移植中的临时腹部关闭是一种安全的手术,其长期存活率与初级带关闭相比较.
- TAC主要用于更复杂的肝移植接受者.
- 尽管短期并发症增加,但TAC不会对患者的长期生存产生负面影响.
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