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同时切口修复和结直肠手术:一步或两步的程序?

M Verdaguer-Tremolosa¹, V Rodrigues-Gonçalves², M P Martínez-López²

¹Department of Surgery, UD of Medicine of Vall d'Hebron, Universitat Autònoma de Barcelona, General and Digestive Surgery Department, Abdominal Wall Surgery Unit, Hospital Universitari Vall d'Hebrón, Passeig Vall d'Hebron 119, 08035, Barcelona, Spain. Mireia.Verdaguer@uab.cat.

Hernia : the journal of hernias and abdominal wall surgery

|September 26, 2024

概括

进行切割修复的结肠直肠手术会增加并发症风险,特别是在并发症患者中. 精心选择患者对于成功的同时手术至关重要,不会影响复发率.

科学领域:

腹壁的重建腹壁的重建
结肠直肠外科手术是什么意思
Hernia 修复 Hernia 的修复

背景情况:

在需要结直肠手术的患者中,切口是常见的.
最佳的外科手术方法 (单相比两步) 仍然不清楚.
评估同时进行手术的并发症至关重要.

研究的目的:

为了比较同时进行腹壁修复和结直肠手术之间的并发症与单独进行切口修复.
确定这些患者群体中并发症的危险因素.

主要方法:

来自EVEREG注册表 (2012-2022) 的成年患者的回顾性分析.
包括接受中线切口修复的患者,单独或与结直肠手术一起.
主要结局:手术部位感染 (SSI);次要结局:克拉维恩-丁多等级,死亡率,复发.

主要成果:

包括7783名患者:256人 (3.3%) 接受了同时的手术,7527人 (96.7%) 单独接受了修复.
同时手术组有更多的并发症和复杂的.
同时治疗组的SSI率显著更高 (55.4%vs30.7%).
对SSI的危险因素包括更高的BMI,吸烟,更大的横穿直径,组件分离和干净污染/污染的手术.
同时治疗组中观察到更高的Clavien-Dindo等级和死亡率.
两组之间的复发率没有显著差异.

结论:

同时进行腹壁修复和结直肠手术与并发症风险增加有关,特别是在患有并发症或复杂的患者中.
谨慎的患者选择对于在同时进行手术时获得令人满意的结果至关重要.
该研究强调了风险因素评估在规划联合手术干预中的重要性.

关键词:

结肠直肠部分结肠直肠部分同时的同时使用.Hernia 这是一个.这是一个切口切口.手术手术手术术术

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