立即视频辅助胸腔镜手术对静脉的有效性:一个多中心,回顾性队列研究
Akihiro Shiroshita1,2,3, Yuya Kimura4, Atsushi Yamada5
1Division of Epidemiology, Department of Medicine, Vanderbilt University School of Medicine, Nashville, Tennessee, USA.
Respiration; international review of thoracic diseases
|August 27, 2023
概括
视频辅助胸腔镜手术 (VATS) 显著减少了医院停留时间和在现实世界中出院的时间. 需要进一步的大规模研究来证实这些发现.
科学领域:
- 胸部外科手术 胸部外科手术
- 肺部病理学 肺部病理学
- 关键护理医学 关键护理医学
背景情况:
- 之前对瘤即时视频辅助胸腔镜手术 (VATS) 的研究存在局限性.
- 在真实世界中,即时VATS对empyema的有效性仍然不清楚.
研究的目的:
- 评估即时的VATS是否改善了empyema患者的临床结果.
- 评估VATS早期干预对死亡率和逗留时间的影响.
主要方法:
- 多中心回顾性队列研究,包括744名恩皮埃马患者 (2006-2021年).
- 暴露:在诊断后3天内使用VATS.
- 结果:30天死亡率,90天死亡率,住院时间,从诊断到出院的时间.
- 倾向性得分权重和回归分析被用来控制混因子.
主要成果:
- 在7.1%的患者中进行了即时的VATS (3天内);92.9%的患者接受了初始的保守治疗.
- 在30天死亡率 (1.18%,95% CI: -10.7至13.0%) 或90天死亡率 (-0.08%,95% CI: -10.3至10.2%) 中,两组之间没有显著差异.
- 立即的VATS显著减少了住院时间 (-3.22天,95%CI: -6.19至-0.25) 和从诊断到出院的时间 (-5.04天,95%CI: -8.19至-1.90).
结论:
- 在现实环境中立即使用VATS可以减少血患者住院的时间和出院的时间.
- 这项研究强调了早期手术干预的潜在益处.
- 由于样本大小和潜在的国际协议变化,建议进行进一步的大规模研究.
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