消化管切除术手术后增强恢复倡议导致改善的结果
Charles R Sims1, Mohamad K Abou Chaar2, Mitchell H Kerfeld1
1Department of Anesthesiology and Perioperative Medicine, Mayo Clinic, Rochester, Minnesota.
The Annals of thoracic surgery
|December 3, 2023
概括
实施多学科食道切除增强恢复计划 (MERIT) 途径减少了食道切除患者的并发症和停留时间. 这项质量改进倡议显示,心房失常症和手术后阴显著减少.
科学领域:
- 手术 手术 手术 术 术
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
背景情况:
- 对于食道癌的食道切除术具有很高的风险.
- 一个多学科的食管切除术增强恢复倡议 (MERIT) 途径被开发来优化护理.
- 这项研究评估了MERIT途径在单一机构的实施结果.
研究的目的:
- 评估MERIT途径在改善食道切除术后患者结果方面的有效性.
- 分析增强恢复途径对并发症率和住院时间的影响.
- 为食道切除术患者实施质量改善倡议.
主要方法:
- 一个回顾性研究比较238个历史对照和58个连续的MERIT途径患者.
- 使用威尔科克森等级总和测试和费舍尔精确测试进行统计分析.
- 患者数据收集于2021年11月1日至2022年6月20日,与历史对照数据 (2017年1月17日至2020年12月30日) 相比.
主要成果:
- 逗留时间减少了27% (11至8天).
- 大心律失常率降低了12% (P=.05).
- 手术后的骨髓减少了9% (P=.01),整体并发症从54%降至35% (P=.01).
结论:
- 对于食道切除术而言,MERIT途径已成功开发和实施.
- 这一途径在第一年内显著减少了整体并发症,心房失常症和术后阴道.
- 这种手术后增强的恢复途径显示了改善食道切除患者护理的前景.
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
90
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
90
Endoscopic Procedures I: Esophagogastroduodenoscopy
124
An Esophagogastroduodenoscopy (EGD) is a diagnostic procedure in which an endoscopist uses a flexible, lighted endoscope to visualize the upper gastrointestinal (GI) tract. The procedure includes visualizing the oropharynx, esophagus, stomach, and the first part of the small intestine, the duodenum.
During an EGD, the endoscope can be used to:
During an EGD, the endoscope can be used to:
124
Peptic Ulcer Disease V: Surgical Management and Nursing Care
309
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
309
Endoscopic Procedures V: ERCP
271
Endoscopic Retrograde Cholangiopancreatography (ERCP) is a diagnostic procedure that combines endoscopy and fluoroscopy to diagnose and treat conditions related to the bile ducts, pancreatic ducts, and gallbladder. This procedure is beneficial for identifying and addressing blockages, gallstones, strictures, and tumors within the biliary or pancreatic systems. ERCP is both diagnostic and therapeutic, offering the ability to visualize and treat identified problems in one session.
Patient...
Patient...
271
Esophageal Perforation-II: Clinical Manifestations and Management
65
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
65
Endoscopic Studies I: Bronchoscopy and Thoracoscopy
210
Endoscopy is a non-surgical medical technique used to examine a person's internal organs and vessels. This lesson will focus on two types of endoscopic studies: bronchoscopy and thoracoscopy.
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
Bronchoscopy
Description
Bronchoscopy is a procedure that involves direct visualization of the larynx, trachea, and bronchi for diagnostic and therapeutic purposes. A flexible fiber optic or rigid bronchoscope is used to carry out the procedure. The fiber-optic bronchoscope is more frequently used due...
210


