隔间手术管理患者入院的急性阻塞由于监禁的食管的
Brexton Turner1, Andrew Kastenmeier1, Jon C Gould2
1Division of Minimally Invasive and Gastrointestinal Surgery, Department of Surgery, Medical College of Wisconsin, 8701 Watertown Plank Rd, Milwaukee, WI, 53226, USA.
Surgical endoscopy
|August 9, 2024
概括
对于稳定,急性监禁的副食道 (PEH) 的保守管理是安全的. 这种方法往往可以避免出现的手术,减少并发症和住院比立即修复.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 紧急医疗 紧急医疗
背景情况:
- 急性监禁性副食道 (PEH) 传统上被视为手术紧急情况.
- 对PEH的紧急手术比选择性手术具有更高的发病率和死亡率风险.
- 对于稳定,阻塞的PEH患者,已经采用了初始保守管理的战略.
研究的目的:
- 评估保守的管理策略的结果,其次是监禁PEH的间隔修复.
- 确定保守管理是否是稳定患者立即手术的安全替代方案.
主要方法:
- 在2019年10月至2023年9月期间接受监禁PEH的患者的回顾性图表审查.
- 排除在入院后24小时内需要手术的患者.
- 对保守管理的患者与需要紧急手术的患者的结局分析.
主要成果:
- 在45名患者中,10名 (22%) 由于不稳定,需要紧急手术.
- 在35名 (66%) 稳定患者中,有23名通过保守管理成功解决了阻塞,并提供了计划性修复.
- 与立即修复相比,保守的管理并没有增加并发症率或总住院时间.
结论:
- 保守的管理是临床稳定患者的安全和有效的初始方法,患者有症状的监禁PEH.
- 这种策略往往可以避免紧急手术,而不会影响患者的安全或增加整体医院资源利用率.
相关概念视频
Esophageal Perforation-II: Clinical Manifestations and Management
54
Esophageal perforations manifest in various clinical forms, influenced by factors such as the perforation's cause and location (cervical, intrathoracic, or intra-abdominal), the extent of contamination, and potential injury to adjacent mediastinal structures. The timing between the perforation occurrence and treatment initiation also affects the clinical presentation.
Clinical Manifestations:
Clinical Manifestations:
54
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
66
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
66
Peptic Ulcer Disease V: Surgical Management and Nursing Care
264
Surgical management and nursing care are crucial in treating Peptic Ulcer Disease (PUD). Here is an organized and enhanced overview of the surgical interventions and the associated nursing care for PUD:
Surgical Interventions for Peptic Ulcer Disease
Surgical Interventions for Peptic Ulcer Disease
264
Inflammatory Bowel Disease V: Surgical Management
134
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:
134
Esophageal Strictures-II: Clinical Features and Management
58
Patients with esophageal strictures often experience a range of symptoms. Initially, they may have difficulty swallowing solid foods, which can progress to include liquids. Additional symptoms may involve chest pain or discomfort, regurgitating food and fluids, heartburn, unintentional weight loss, coughing or choking during meals, and hoarseness.
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
Healthcare providers should gather a comprehensive medical history and conduct a physical examination for diagnosis. If esophageal stricture is...
58
Enteral Nutrition II: Nasointestinal and Gastrostomy Feeding
95
Enteral nutrition encompasses various methods of delivering nutrition directly to the gastrointestinal (GI) tract, bypassing traditional oral intake. It is particularly beneficial for patients who cannot eat by mouth but have a functioning digestive system. Key methods include nasointestinal feeding, gastrostomy, and jejunostomy, each suited to different clinical scenarios based on the patient's needs and condition.
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
Nasointestinal Feeding
Nasointestinal feeding involves placing a tube...
95


