粘性小肠阻塞:腹腔镜失败的预测因素
Marta Morelli1, Silvia Strambi1, Camilla Cremonini1
1General and Emergency Unit and Trauma Center, New Santa Chiara Hospital, University of Pisa, Via Paradisa, 2, 56021, Pisa, Italy.
Updates in surgery
|December 27, 2023
概括
对于粘性小肠阻塞 (ASBO) 的腹腔镜手术是有效的,尽管转化率有所不同. 影像成像中的"便标志"可能预测需要进行开放性手术,有助于患者选择.
科学领域:
- 腹部外科手术 腹部外科手术
- 最少侵入性手术的方法
- 胃肠道手术 胃肠道手术
背景情况:
- 粘性小肠阻塞 (ASBO) 管理通常涉及手术干预.
- 腹腔镜手术提供了潜在的好处,但面临着挑战,包括转换为开放手术.
- 在腹腔镜ASBO病例中转换的预测因素仍然不完全理解.
研究的目的:
- 确定与ASBO患者从腹腔镜转换为开放手术相关的因素.
- 评估手术前成像研究结果在预测转化风险方面的有用性.
主要方法:
- 对接受腹腔镜手术的168名ASBO患者 (2014年12月 - 2022年10月) 的回顾性分析.
- 完整腹腔镜 (第一组) 和转换为开放 (第二组) 组之间的人口统计,临床,放射学,术内和术后数据的比较.
- 单变量和多变量分析以确定转换的预测因素.
主要成果:
- 第二组 (转化) 显示出明显更高的缺血,手术并发症,手术时间,鼻胃管使用,道化时间和住院时间.
- 单变量分析确定了与转化相关的"便标志"和腹腔内自由液的高放射密度.
- 多变量分析证实"便标志"是转化的一个显著预测因素 (OR 1.965).
结论:
- 腹腔镜手术是ASBO的安全和有效的治疗选择.
- "便标志"是ASBO患者转换为开放手术的有价值的术前预测指标.
- 识别像"便标志"这样的预测因素可以帮助外科医生优化ASBO患者选择和手术策略.
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