对半选择性和选择性手术后的短期结果进行比较分析,用于西格体卷积
Bailey Hilty Chu1, Anthony Loria2, Xueya Cai3
1Department of Surgery, Surgical Health Outcomes and Reaching for Equity (SHORE), University of Rochester Medical Center, NY.
Surgery
|August 27, 2024
概括
在sigmoid volvulus减压后的选择性手术是安全的,并且与比半选择性手术更好的结果有关. 这表明,仔细选择患者进行选择性手术可能会改善这种疾病的护理.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 胃肠道手术 胃肠道手术
- 手术结果研究研究.
背景情况:
- 有限的数据存在于最佳的外科手术时间后结肠解压对于西格体卷积.
- 了解术后结果对于指导手术决策至关重要.
研究的目的:
- 为了比较半选择性和选择性手术之间的术后结果,在结肠压缩减压后,对西格体卷进行选择性手术.
- 评估不同手术时间策略的安全性和有效性.
主要方法:
- 医疗保险数据 (2016-2019) 对65岁以上的患者进行了回顾性审查,这些患者接受了减压和手术,以治疗西格体卷发症.
- 分析包括2053名患者,基于半选择性 (指数住院期间) 与选择性 (随后住院) 手术的结果进行了比较.
主要成果:
- 选择性手术 (7%的患者) 显示了较高的微创手术率 (32.8%vs12.6%) 和离院率 (89.8%vs47.4%).
- 半选择性手术与明显较低的骨髓形成率相关 (2.9%与36.0%相比).
- 与半选择性手术相比,多变量分析表明,选择性手术降低了发病率 (OR 0.60),死亡率 (OR 0.79) 与半选择性手术相似.
结论:
- 选择性手术后的结肠压缩减压对西格体卷积与有利的术后结果有关,并似乎是安全的.
- 这些发现凸显了对算法预测复发风险和指导患者选择选择性手术的需求.
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