在食道切除术中结肠间接:ACS-NSQIP研究
Beatrix Hyemin Choi1, James Church2, Joshua Sonett3
1Colorectal Surgery, Columbia University Irving Medical Center/New York Presbyterian Hospital, 161 Ft. Washington Avenue, Floor 8, New York, NY, 10032, USA. hmc2164@cumc.columbia.edu.
胃拉伸 (GPU) 和结肠插入 (CI) 是食道切除术的重建方法. 虽然CI的复手率较高,但患者的脆弱性,而不是手术本身,可能解释了结果的差异.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 医学数据库 医学数据库
背景情况:
- 用胃拉伸 (GPU) 或结肠插入 (CI) 的食道切除术在癌症或受伤后重建食道.
- 这两种手术都旨在恢复功能,但与患者显著的发病率有关.
研究的目的:
- 为了比较胃拉伸 (GPU) 和结肠插入 (CI) 之间的结果,用于食道重建.
- 确定影响这些程序中的重新操作,再接收和死亡率的因素.
主要方法:
- 美国外科医生学院国家外科质量改进计划 (ACS-NSQIP) 数据库的分析.
- 包括2006年至2020年期间接受GPU或CI的患者.
- 统计分析包括单变量和多变量逻辑回归来评估结果.
主要成果:
- 分析了12545名GPU和502名CI患者.
- 结肠插入 (CI) 与更长的住院时间和更高的重新手术率 (23.9%与14.5%) 相关.
- 多变量分析表明CI增加了重新手术的风险,但不是再入院或死亡率,这表明患者的脆弱性是关键因素.
结论:
- 结肠插入 (CI) 是一个可行的选择,当胃重建是不可行的.
- 观察到的结果差异很可能归因于患者的并发症和虚弱,而不是CI固有的风险.
- 需要对食道重建的患者选择和风险分层进行进一步的研究.
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