转移中的决策:肠静脉切除与结肠动症的初级解剖切除
Utsav Patwardhan1, Dylan Griffiths2, Gerald Gollin3
1Rady Children's Hospital San Diego, Division of Pediatric Surgery, 3020 Children's Way, San Diego, CA 92123, USA; Naval Medical Center San Diego, Department of Surgery, 34800 Bob Wilson Drive, San Diego, CA 92134, USA.
结肠 (CA) 在9.5%的婴儿中发生在希尔施普隆病 (HD) 时. 对于CA的初级解肠切除是安全有效的,与初始转移相比,导致更好的结肠细分保留,并发症率相似.
科学领域:
- 儿科外科手术 儿科外科手术
- 胃肠病学 胃肠病学
- 新生儿护理 新生儿护理
背景情况:
- 大肠动 (CA) 是一种罕见的先天性异常.
- 同时的赫施普朗格病 (HD) 在高达10%的病例中使CA复杂化.
- 癌症的外科治疗往往涉及最初的转移,因为人们担心存在着HD.
研究的目的:
- 为了确定与CA.同时患有HD的婴儿同时患HD的发病率.
- 为了评估当前的外科实践模式,关于转移CA.
- 为了比较初级解与CA的初始转移的结果.
主要方法:
- 对儿科健康信息系统 (PHIS) 数据库 (2013-2022) 的回顾性审查.
- 纳入标准:患有CA的婴儿,不包括其他特殊形或晚期首次手术的婴儿.
- 分析指数和后续手术,并发症,关闭的时间和计划外的重新手术.
主要成果:
- 在CA患者中,Hirschsprung病 (HD) 被诊断为9.5%;在这些8名婴儿中,有7名婴儿经历了初始转移.
- 69%的CA患者初始转移,33%的患者患有骨质疏通.
- 原发性解剖解剖导致更频繁的乳头结肠或结肠结肠解剖,与转移相比,手术较少,并发症率相似.
结论:
- 同时的HD影响9.5%的CA婴儿,大多数都经历了初始转移.
- 对于CA来说,初级解肠术是一种安全有效的策略,与更好的近端结肠片段保留有关.
- 术内结肠活检可以指导CA中的安全初级解剖,从而可能避免不必要的转移.
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