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样本提取地点对手术后的切口的作用 在最小侵入性右侧大肠切除术后
Josh A Johnson1, Andrea Mesiti1, Margo Herre1
1From the Department of Surgery, Weill Cornell Medicine, New York Presbyterian Hospital, New York, NY (Johnson, Mesiti, Herre, Zambare, Pigazzi, Jafari).
Journal of the American College of Surgeons
|February 28, 2024
概括
与中线提取相比,Pfannenstiel样本提取显著降低了最小侵入性右侧切除术后的切割性 (IH) 风险. 这一发现有助于选择手术地点,以改善患者的治疗结果和预防术后并发症.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 最少侵入性的手术
- 手术结果研究研究.
背景情况:
- 切口 (IH) 是结直肠手术后的一个常见并发症.
- 至少侵入性技术仍然需要样本提取地点,这有助于IH风险.
- 了解提取部位的影响对于预防术后内脏炎至关重要.
研究的目的:
- 为了评估样本提取地点对最小侵入性右侧切除术后IH率的影响.
- 为了比较中线和Pfannenstiel提取地点之间的IH发病率.
- 为了确定与IH在切除术后发展相关的风险因素.
主要方法:
- 追溯多机构队列研究 (2012-2020年).
- 包括接受微创右切除术并进行术后成像的成年人.
- 主要暴露:中线与Pfannenstiel样本提取;主要结果:术后≥1年内IH的发展.
主要成果:
- 中线提取 (57%) 与Pfannenstiel提取 (0%) 相比,与显著更高的IH率 (25%) 相关.
- 中线提取患者年龄较大,并且之前有更多的腹部手术.
- 中线提取 (OR 24.6) 和体外解剖 (OR 25.8) 独立地与IH发展有关.
结论:
- 取出Pfannenstiel样本与较低的切口发育风险有关.
- 抽取样本的手术部位选择可以影响手术后的IH率.
- 选择Pfannenstiel提取可能是一种策略,以减轻右侧切除术中的IH风险.
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