扩展与有限的中腔切除对于手术性克罗恩病:来自ACS-NSQIP数据库的30天结果
Shafic Abdulkarim1, Ebram Salama2, Allison J Pang2
1Department of Surgery, McGill University, Jewish General Hospital, 3755 Cote Ste Catherine, G-317, Montreal, QC, Canada. Shafic.abdulkarim@mail.mcgill.ca.
International journal of colorectal disease
|November 18, 2023
概括
在克罗恩氏病 (CD) 切除术中,延长间膜切除 (ME) 不会增加30天重大手术发病率. 这一发现解决了人们对与CD更广泛的外科手术技术相关的术后并发症的担忧.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 炎症性肠道疾病是什么
背景情况:
- 建议扩展中腔切除 (ME) 以减少克罗恩病 (CD) 的重新干预率.
- 临床担忧仍然存在,即延长性ME的术后发病率可能增加.
- 这项研究评估了扩展ME在CD切除术中的安全性.
研究的目的:
- 为了在CD的细分切除术中比较有限和扩展ME之间的30天外科手术期间的发病率.
- 确定延长性ME是否是CD患者主要发病率的独立预测因素.
主要方法:
- 对ACS-NSQIP专用胆管切除术数据库 (2014-2019) 的回顾性分析.
- 包括接受针对非恶性征兆的细分切除术的CD患者.
- 扩展性ME被定义为12个或更多节点的淋巴结收获;主要结果是NSQIP主要发病率.
主要成果:
- 分析了3,709名患者;3,087人患有有限的ME,622人患有延长的ME.
- 单变量分析显示,在有限和扩展的ME组之间,主要发病率没有显著差异.
- 多变量回归证实ME的程度不是主要发病率,腹部并发症或术后出血的独立预测因素.
结论:
- 对于克罗恩氏病小肠切除术而言,延长的中肠切除与30天外科手术期间主要发病率的增加无关.
- 这些发现表明,扩展的ME可以在CD手术中安全地使用,而不会在短期内损害患者的安全.
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