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减少长期肠道阻塞的风险,通过最少的侵入性腹膜的修复

Gerard R Martusciello¹, Gwyneth A Sullivan¹, Nathaniel Koo¹

¹Division of Pediatric Surgery, Department of Surgery, Rush University Medical Center, Chicago, Illinois.

The Journal of surgical research

|October 27, 2023

概括

对于先天性隔膜 (CDH) 修复的最小侵入性手术 (MIS) 显著降低了小肠阻塞 (SBO) 的长期风险. 与开放手术相比,MIS方法为儿科CDH修复提供了更安全的替代方案.

科学领域:

儿科手术儿科手术
外科手术的结果
胃肠道手术胃肠道手术

背景情况:

对先天性隔膜 (CDH) 修复的最小侵入性手术 (MIS) 提供了诸如更短的住院时间和更好的美观等好处.
虽然MIS与成人长期小肠阻塞 (SBO) 的减少有关,但其对儿科CDH修复结果的影响不太清楚.

研究的目的:

为了比较小肠阻塞 (SBO) 的率,在儿科患者中进行先天性隔膜 (CDH) 修复的开放式和最小侵入性手术 (MIS) 后.

主要方法:

使用PearlDiver Mariner数据库对在2010年至2021年期间接受CDH修复的儿科患者进行了回顾性分析.
采用卡普兰-梅尔曲线和考克斯比例危险模型来评估到SBO的时间,并根据网状网的使用,性别和停留时间进行调整.

主要成果:

该研究包括1033名患者,其中25.0%接受了MIS修复. 总体的SBO率为7.5%,达到7.5%.
与手术后1,3年和5年的开放修复相比,SBO的发生率在MIS中始终较低 (P=0.004).
经调整后的分析证实,MIS维修与SBO的明显较低率相关 (调整后的危险比:0.37).

结论:

最少侵入性手术 (MIS) 方法与先天性隔膜 (CDH) 修复后小肠阻塞 (SBO) 的长期率降低有关.
在为儿科CDH患者选择手术方法时,SBO的长期风险应该是关键考虑因素.

关键词:

生产性腹膜 (CDH) 发生.最少侵入性手术 (MIS) 是一种最少侵入性的手术.小肠阻塞 (SBO) 是一种小肠阻塞.

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