腹腔镜手术对结直肠穿孔的有用性:单中心回顾性队列研究
Nobuhisa Tanioka1, Michio Kuwahara2, Hiromichi Maeda3
1Department of Surgery, Hata Kenmin Hospital, 3-1 Yoshina, Yamanacho, Sukumo-City, Kochi, 788-0785, Japan.
Surgery today
|June 25, 2024
概括
对结直肠穿孔的腹腔镜手术显著减少了手术部位的感染,而不会增加死亡率或严重的并发症. 这种最少的侵入性方法为治疗肠道穿孔提供了一个更安全的替代方案.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 最少侵入性的手术
背景情况:
- 结直肠穿孔是一个关键的外科紧急情况.
- 对腹腔镜手术用于结直肠穿孔的证据有限.
- 开放式手术一直是传统的方法.
研究的目的:
- 评估腹腔镜手术对结直肠穿孔的安全性和有效性.
- 为了比较腹腔镜和开放外科手术方法之间的结果.
- 为了解决这个特定的外科领域缺乏证据的问题.
主要方法:
- 70名结直肠穿孔患者的回顾性队列研究 (2017年1月至2023年12月).
- 开放式 (n=28) 和腹腔镜 (n=42) 手术之间的手术结果的比较.
- 主要终点:术后死亡率和并发症;次要终点:失血,手术时间,住院,一年生存率.
主要成果:
- 两组之间在术后死亡率或严重并发症方面没有显著差异.
- 腹腔镜手术显示,表面和深切切口手术部位感染率显著降低 (0.0%对35.7%,p<0.001).
- 腹腔镜手术的手术时间较长 (290.0±102.3分 vs 175.6±92.2分,p<0.001),但类似的血液损失,住院和1年生存率.
结论:
- 对于结直肠穿孔的腹腔镜手术显著减少了手术部位感染.
- 该程序在死亡率和严重并发症方面显示出与开放手术相比的安全性.
- 最少侵入性技术为管理结直肠穿孔提供了一种可行且潜在的优越选择.
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