重新考虑术后护理:同一天的结节切除术关闭放出改善了患者的治疗结果
Davide Ferrari1, Tommaso Violante2, Abdullah Bin Zubair3
1Division of Colon and Rectal Surgery, Department of Surgery, Mayo Clinic, Rochester, Minnesota, United States; General Surgery Residency Program, University of Milan, Milan, Italy.
概括
转回环结节术 (DLI) 关闭后的当天出院 (SDD) 是安全有效的,比标准增强恢复途径 (ERP) 导致的并发症少. 这种方法可能成为DLI关闭的新护理标准.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 外科手术的结果
- 增强的恢复途径
背景情况:
- 增强的恢复途径 (ERP) 在结直肠外科手术中已经发展起来,为精选的患者提供了当天出院 (SDD).
- 对于转回环结节切除术 (DLI) 关闭,SDD的广泛采用仍然有限,到2016年,只有4.1%的病例使用SDD.
研究的目的:
- 为了比较SDD DLI关闭的结果与DLI关闭的结果,按照标准ERP.
- 评估SDD对DLI关闭的安全性和有效性.
主要方法:
- 一项追溯案例匹配研究将125名接受SDD DLI关闭的患者与250名接受标准ERP DLI关闭的患者进行了比较.
- 匹配标准包括年龄,性别,ASA分数,BMI,手术日期,潜在疾病和医院地点.
- 主要结局是比较的30天并发症率.
主要成果:
- 与标准ERP组 (1221.1 ± 416.6毫升) 相比,SDD组接受的手术内液体较少 (1039.0 ± 368.3毫升).
- 30天的术后并发症率在SDD组 (14.8%) 与标准ERP组 (25.7%) 相比显著较低.
- 在SDD组中,阴茎发病率低于标准ERP组 (14.8%),而在SDD组 (9.6%) 中,阴茎发病率低于标准ERP组 (14.8%),再接收或再操作率没有显著差异.
结论:
- 同一天出院 (SDD) 结肠关闭是一个安全,可行的和有效的程序.
- 与标准ERP相比,SDD DLI关闭的并发症较少.
- 需要进一步的前性试验来证实这些发现,并将SDD作为新的护理标准.
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