在前椎手术后食道穿孔
Aitua C Salami1, Madhuri Rao1, Jonathan Berger1
1Division of Thoracic and Foregut Surgery, University of Minnesota, Minneapolis, Minn.
JTCVS techniques
|June 20, 2024
概括
在前椎外科手术后食道穿孔的开放性伤口治疗导致愈合速度更快,并且与闭伤相比,手术更少. 这种方法改善了这种罕见并发症患者的治疗结果.
科学领域:
- 医学 医学 医学 医学 医学
- 外科手术 手术手术
- 胃肠病学 胃肠病学
背景情况:
- 食道穿孔是前椎手术的罕见但严重并发症.
- 管理策略旨在实现迅速治愈,并尽量减少发病率.
研究的目的:
- 为了比较前椎手术后食道穿孔的封闭与开放伤口管理的结果.
- 更新管理这种特定的外科并发症的经验.
主要方法:
- 对13名患有从前椎手术 (2007-2020) 造成食道穿孔的患者的回顾性审查.
- 关闭 (切口过排水) 和开放 (二次意图) 伤口管理之间的结果比较.
- 收集的数据包括人口统计,操作细节,解决率,解决时间,需要的程序和停留时间.
主要成果:
- 开放组 (7名患者) 显示100%的解决率,在30天内100%的解决,中位数为1次手术,中位数为14天的住院时间.
- 封闭组 (6名患者) 的治愈率为80%,30天内治愈率为20%,中位数为3次手术,中位数为住院23天.
- 在开放组中,由于ARDS和吸收,发生了两起早期术后死亡.
结论:
- 食道穿孔后前椎手术需要多学科管理,包括排水,修复,硬件移除和肠道接入.
- 建议进行开部伤口管理,以缩短治疗时间,手术次数和住院时间.
相关概念视频
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