在患有急性尾炎的患者中,从腹腔镜切除术转换为开放尾术的风险因素的确定
Cem Azılı1, Serhat Tokgöz2, Bourak Chousein2
1Department of General Surgery, Ankara University Faculty of Medicine, Division of Surgical Oncology, Ankara-Türkiye.
概括
确定转换腹腔镜尾切除术为开放手术的危险因素至关重要. 晚年,较高的ASA分数和升高的胆红素水平预测转化,这与增加的并发症和死亡率有关.
科学领域:
- 手术紧急情况的管理.
- laparoscopic 手术 的 结果 .
背景情况:
- 急性尾炎是一种常见的手术紧急情况.
- 区分腹腔镜尾切除术 (LA) 和开放手术 (OA) 的情况可能是具有挑战性的.
- 从LA转换为OA的风险因素的识别旨在防止并发症.
研究的目的:
- 为了确定从腹腔镜切除术转换为开放尾切除术的预测因素.
- 分析与尾炎手术中并发症增加相关的风险因素.
主要方法:
- 对634名经过腹腔镜尾切除术的成年患者进行了回顾性分析.
- 在LA和转换OA (COA) 组之间比较人口统计数据,外科手术期间的因素和结果.
- 统计分析以确定转换的重要预测因素.
主要成果:
- 19.2%的患者需要转换为OA.
- 对COA的预测因素包括晚年 (>65岁),美国麻醉学会 (ASA) 较高的得分 (>2),胆红素升高和CT扫描使用增加.
- 冠状炎患者经历了更长的手术时间,延迟的口服,更高的复杂尾炎,手术部位感染,再手术,再入院和死亡率.
结论:
- 晚年,升高的胆红素,ASA>2分,CT扫描使用预测转换到OA.
- 转换为OA与明显更高的术后并发症和死亡率有关.
- 在手术前确定患有转化风险的患者可能有助于减轻并发症.
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