对于复发性直肠漏洞修复的持久方法可能需要避免索引程序
Liliana Bordeianou1, James W Ogilvie2, Julia T Saraidaridis3
1Department of Surgery, Pelvic Floor Disorders Center, Massachusetts General Hospital and Harvard Medical School, Boston, Massachusetts.
Diseases of the colon and rectum
|March 13, 2024
概括
复发性直肠的手术修复是可行的,短期复发率与初始修复相似. 然而,重复手术通常需要不同的手术方法,而不是指数手术的最佳结果.
科学领域:
- 结肠直肠外科手术是什么意思
- 骨盆底疾病 骨盆底疾病
背景情况:
- 由于先前的干预措施,复发性直肠脱落会带来独特的手术挑战.
- 现有的数据是有限的,以确定最佳的手术方法在复发性失落的情况下.
研究的目的:
- 为了评估当前的手术策略,为患者有史以来的直肠脱落修复.
- 为了比较初始 (de novo) 和重复 (redo) 脱落手术之间的短期结果,包括复发率.
主要方法:
- 一个前性的多中心质量改进数据库的回顾性分析.
- 包括来自25多个高体积手术场所的非识别数据.
- 进行初级修复的患者与直肠脱落的重修患者之间的结局的比较.
主要成果:
- 几乎20%的患者 (89/461) 接受了重复直肠脱落修复.
- 短期随访显示,重复修复与新修复的复发率相似.
- 重复手术通常需要使用与最初手术不同的手术技术.
结论:
- 复发性直肠的手术纠正是可以实现的,与初级修复相比,短期的耐用性可比.
- 考虑重复手术的替代性手术方法可能是合理的.
- 需要进一步研究用于治疗复发性脱落的最佳手术技术.
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