附着性肠道阻塞的风险在患有尾炎的儿童:一个系统的审查
Neel Doshi1, Soham Bandyopadhyay1, Madeline Green1
1University of Oxford and Oxford University Hospitals, Headley Way, Headington, Oxford, OX3 9DU, United Kingdom.
Journal of pediatric surgery
|April 2, 2024
概括
复杂的尾炎几乎使儿童的粘性肠道阻塞的风险增加了一倍. 手术方法 (拉巴镜 vs 开放) 并没有显著改变这种风险.
科学领域:
- 儿科手术 儿科手术
- 胃肠道手术 胃肠道手术
- 手术结果研究研究.
背景情况:
- 复杂的尾炎具有较高的术后并发症风险,特别是粘性肠道阻塞.
- 了解儿科尾炎中粘性肠道阻塞的发生率对于患者的管理至关重要.
- 外科手术对阻塞率的影响需要进一步研究.
研究的目的:
- 为了比较患有复杂和简单尾炎的儿科患者手术后肠道阻塞的发生率.
- 评估手术方法 (开放式 vs. 腹腔镜) 对复杂尾炎中粘性肠道阻塞率的影响.
主要方法:
- 按照PRISMA指南进行了一次系统的文献审查.
- 从MEDLINE,Embase和Cochrane图书馆提取了1998年至2022年间发表的研究数据.
- 聚合分析包括6项关于尾炎复杂性的研究 (58,962例) 和10项关于手术方法的研究 (62,433例).
主要成果:
- 复杂尾炎与小肠阻塞 (SBO) 的发生率增加两倍相关 (合并OR 2.02).
- 在复杂尾炎的开放式和腹腔镜方法之间没有观察到SBO率的显著差异 (合并OR为0.93).
结论:
- 复杂尾炎与粘合性肠道阻塞率增加两倍有关.
- 虽然腹腔镜手术提供了整形方面的好处,但其在降低粘合性肠道阻塞风险方面的优越性并未得到当前证据的确支持.
- 在管理复杂尾炎时,应优先考虑外科专业知识,而不是方法 (尾镜与开放式),以减轻阻塞风险.
相关概念视频
01:22Appendicitis-I: Introduction
128
The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
128
01:29Appendicitis-II: Diagnostic Studies and Management
80
Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
80
01:21Inflammatory Bowel Disease V: Surgical Management
145
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
145
01:30Inflammatory Bowel Disease II: Crohn's Disease
233
Introduction
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
Inflammatory bowel disease, commonly known as IBD, refers to a collection of disorders that lead to persistent inflammation of the gastrointestinal tract. The two types of IBD are ulcerative colitis, which impacts the colon, and Crohn's disease, which can involve any part of the gastrointestinal segment.
Crohn's disease
Crohn's disease is a chronic, systemic inflammatory bowel disease (IBD) that predominantly affects the gastrointestinal tract. It is marked by...
233
01:27Inflammatory Bowel Disease I: Ulcerative Colitis
179
Introduction
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
Inflammatory bowel disease, or IBD, encompasses a group of disorders characterized by chronic inflammation or ulceration of the gastrointestinal tract.
Risk Factors
The exact cause of IBD remains unclear, although it is believed to be due to a mix of genetic, environmental, microbial, and immune factors. Genetic factors are significant in determining susceptibility to IBD, with family history being a critical risk factor. Individuals with a first-degree relative who has IBD are at...
179
01:25Assessment of the Rectum and Anus
208
Evaluating the rectum and anus plays a crucial role in conducting a thorough physical examination of the gastrointestinal system. Although it may be uncomfortable and often embarrassing for the patient, it holds immense diagnostic value, particularly in detecting gastrointestinal diseases and abnormalities. This guide will explain how to perform this assessment using inspection and palpation methods.
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
Rectal Inspection
Begin by inspecting the perianal and anal areas for color, texture, rashes,...
208