拉巴罗镜与儿童小肠阻塞指数开放管理的比较研究
Utsav M Patwardhan1, Gretchen M Floan1, Richard Y Calvo2
1Naval Medical Center San Diego, 34800 Bob Wilson Dr, San Diego, CA 92134, USA.
Journal of pediatric surgery
|November 17, 2023
概括
儿科粘性小肠阻塞 (ASBO) 的腹腔镜手术越来越多地使用,并且比开放手术提供更好的结果,包括更少的并发症和更短的住院时间. 每种方法的好处和风险都需要仔细考虑.
科学领域:
- 儿科外科手术 儿科外科手术
- 胃肠道手术 胃肠道手术
- 最少的侵入性手术是最少的侵入性手术.
背景情况:
- 关于儿童粘性小肠阻塞 (ASBO) 的最佳治疗策略的文献有限.
- 对比腹腔镜 (LAP) 和开放 (OPEN) 的手术方法对于儿科ASBO至关重要.
研究的目的:
- 为了比较腹腔镜手术与儿科粘合性小肠阻塞的开放手术的发生率和结果.
- 分析随着时间的推移,手术管理和相关并发症的趋势.
主要方法:
- 加利福尼亚州全州数据库 (2007-2020) 的回顾性分析.
- 包括患有ASBO指数的儿科患者 (<18岁),不包括非手术治疗的病例.
- 主要结果:手术管理类型 (LAP与OPEN);次要结果:医院特征,人口统计和术后并发症.
主要成果:
- 在研究期间,腹腔镜手术的使用量增加,特别是在年长的儿童中.
- 与OPEN相比,LAP与总体并发症显著减少,肠切除率较低,停留时间较短 (LOS) 和TPN使用减少有关.
- 死亡率在各组之间是相同的,而LAP的再接收率较低,但再接收的时间相似.
结论:
- 儿科ASBO的腹腔镜手术已经显示出越来越多的利用率和优异的结果,涉及并发症,LOS,TPN使用和再录取.
- 在较小的儿童中,腹腔镜方法不太常见,这表明需要对每个患者的益处和风险进行权衡.
- 进一步的研究可能会探索影响儿科ASBO腹腔镜和开放手术之间的选择的因素.
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