慢性异常性便秘的手术:儿科和成人患者 - 系统性审查
Kerry A Swanson1, Hannah M Phelps1, William C Chapman1
1Department of Surgery, Washington University in St. Louis, St. Louis, Missouri, United States.
慢性异常性便秘 (CIC) 的手术治疗方法在儿童和成人之间有所不同. 虽然这两种手术方法都能改善症状,但在儿科患者中,前级失禁水泡 (ACE) 程序的并发症率比成人切除更高.
科学领域:
- 胃肠病学 胃肠病学
- 儿科手术 儿科手术
- 结肠直肠手术 结肠直肠手术
背景情况:
- 慢性异常性便秘 (CIC) 在儿科和成人患者中存在类似的挑战,但手术干预措施有很大差异.
- 本系统性审查比较了不同年龄组中CIC的手术管理趋势和结果.
研究的目的:
- 系统地审查和比较儿童和成人患者中CIC的外科治疗趋势和结果.
主要方法:
- 从1995年到2020年,在主要数据库 (Ovid MEDLINE,Embase,Scopus,Cochrane,ClinicalTrials.gov) 中进行了全面的文献搜索.
- 包括的研究涉及被诊断患有CIC的患者,接受手术切除或前期失禁阴囊 (ACE) 程序.
- 评估的主要结果包括排便频率,疼痛,药使用,患者满意度,并发症和重新干预.
主要成果:
- 成年人主要接受切除 (94%),而儿科患者主要接受ACE手术 (96%).
- 这两种手术方法都证明了CIC症状的改善.
- 与切除相比,ACE手术与更高的并发症和重新干预发生率有关.
结论:
- 对于CIC的外科手术策略有所不同,在儿科中偏爱ACE手术,在成人中偏爱切除.
- 关于切除和ACE手术在儿科CIC的长期结果的进一步研究是有必要的,以指导最佳的手术选择.
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