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随着和没有早期的最终手术管理的sigmoid volvulus的结果:20年在第三级转诊中心的经验
Shriranshini Satheakeerthy1, Priscilla Leow1, Benjamin Hall1
1Department of General Surgery, Waikato Hospital, Hamilton, New Zealand.
ANZ journal of surgery
|August 26, 2023
概括
西格体卷发症在西方国家是一种罕见的疾病,经常影响老年患者. 早期的sigmoid colectomy可能会降低与非手术治疗相关的高复发率和死亡率.
科学领域:
- 胃肠病学 胃肠病学
- 外科胃肠道外科手术
- 流行病学 流行病学
背景情况:
- 西格体卷发症在西方人群中不常见,通常影响具有并发症的老年患者.
- 在没有手术干预的情况下观察到很高的复发率 (西格结肠切除术),但手术指示仍在争论中.
研究的目的:
- 分析患者的特征,管理策略和西格体卷发症的结果.
- 评估与手术对比非手术治疗的复发率和死亡率,与sigmoid volvulus.
主要方法:
- 在2000年至2020年期间被诊断患有西格体卷发症的患者的回顾性观察性研究.
- 数据收集包括患者人口统计,临床表现,诊断调查,治疗方法和患者的结果.
主要成果:
- 132名患者经历了203次发作;中位数年龄76岁,中位数查尔森并发症指数 (CCI) 4.
- 33.3%的患者在初次入院期间接受了手术,55.3%的患者在任何阶段都接受了手术. 非手术治疗导致48.8%的患者复发,66.7%的患者在6个月内复发.
- 12个月的死亡率为32.6%. 晚年,异常的生命体征和较高的CCI与死亡率的增加有关.
结论:
- 在最初的Sigmoid Volvulus呈现时,应该考虑进行Sigmoid Colectomy.
- 非操作性管理导致高复发率,其中很大一部分发生在早期.
- 西格体卷发症的死亡率仍然很高,特别是在复发性发作中.
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