在腹腔镜直肠切除术中常规的外周外科导管放置的必要性:回顾性数据分析
A Koehler1,2, F Koch3, M El-Ahmar3
1Clinic for General and Visceral Surgery, Helios Clinics in Schwerin, University Campus of the MSH Medical School Hamburg, Wismarsche Strasse 393-397, Schwerin, 19055, Germany. anja.koehler2@helios-gesundheit.de.
Langenbeck's archives of surgery
|August 25, 2023
概括
在微创性结直肠手术中,外周麻醉不需要. 省略外周麻醉并没有增加并发症或疼痛,这表明它可以安全地排除在这些程序之外.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 麻醉学 麻醉学
- 在瘤学瘤学.
背景情况:
- 外周麻醉 (EDA) 对于改善结直肠手术术后结果的必要性仍在争论中.
- 微创性结直肠瘤切除越来越常见.
研究的目的:
- 评估在接受微创性结肠直肠瘤手术的患者中省略外围麻醉 (EDA) 的影响.
- 为了比较接受EDA和接受横向腹部平面 (TAP) 块的患者之间的结果.
主要方法:
- 对385名接受微创性结直肠瘤切除术的患者进行了回顾性分析.
- 对接受EDA (I组) 的183名患者和接受TAP阻断剂 (II组) 的202名患者的结果进行比较.
- 术后并发症使用克拉维恩 - 丁多分类来进行分级.
主要成果:
- 第一组 (EDA) 患者年轻,需要更多的尿路导管,更长的血管压缩剂治疗,并且在中间护理单位停留时间更长.
- 两组之间没有观察到术后疼痛水平或并发症发生率 (出血,静脉泄漏,伤口感染) 的显著差异.
- 与II组相比,I组的患者出现了延迟的行走和显著更长的整体住院时间.
结论:
- 在选择性的微创性结直肠切除中,可以安全地省略外周麻醉.
- 省略EDA不会导致患者不良后果或增加并发症.
- 在这些程序中,横向腹部平面块可能是EDA的合适替代品.
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