laparoscopic colectomy 对于美国麻醉学会 (American Society of Anesthesiology) 较差分类的患者来说
Keisuke Noda1, Takashi Nonaka1, Tetsuro Tominaga1
1Department of Surgical Oncology, Nagasaki University Graduate School of Biomedical Science, Nagasaki, Japan.
Asian journal of endoscopic surgery
|October 2, 2024
概括
腹腔镜手术是对美国麻醉学会 (ASA) 性能状况 (PS) 较差的结直肠癌患者的安全和有效选择. 与开放手术相比,这种方法导致并发症减少,住院时间缩短.
科学领域:
- 手术瘤学手术瘤学
- 麻醉学 麻醉学
- 胃肠病学 胃肠病学
背景情况:
- 美国麻醉学会 (ASA) 的分类系统对于评估手术患者的健康状况至关重要.
- 腹腔镜手术对于患有ASA性能状态 (PS) 损害的结直肠癌患者的适用性尚未得到充分确立.
研究的目的:
- 调查外科手术对大肠直肠癌患者手术后并发症的影响,ASA-PS ≥3.3.
- 为了在这个患者队伍中比较开放式和腹腔镜手术之间的结果.
主要方法:
- 在2016年至2023年期间,对458名ASA-PS≥3的结直肠癌患者进行了回顾性审查,他们接受了手术.
- 患者被分为开放式手术 (n=80) 和腹腔镜手术 (n=378) 组.
- 分析的重点是术后并发症,手术时间,血液损失和住院时间.
主要成果:
- 腹腔镜手术与开放手术相比,血流明显减少 (23毫升 vs. 156毫升),术后并发症减少 (25.1% vs. 40.0%),住院时间缩短 (14天 vs. 23天).
- 开放式手术和较长的手术时间被确定为术后并发症的独立预测因素.
- 腹腔镜组的手术时间更长 (170分钟与233分钟相比).
结论:
- laparoscopic手术证明了对结肠直肠癌患者的良好结果,这些患者的ASA-PS.
- 这些发现支持在这种高风险的手术群体中使用腹腔镜技术.
- 最少侵入性的方法可以改善患者的康复和降低发病率.
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