结直肠和/或结直肠门缩中良性静脉狭窄的技术风险因素:一个回顾性病例控制研究
Zoe Garoufalia1, Sarinya Meknarit2, Sameh Hany Emile1,3
1Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA.
概括
预防结肠直肠静脉狭窄症涉及脏曲动员和中腔血管高绑定. 避免使用25毫米合器和多次发射,可以降低结直肠手术后狭窄风险.
科学领域:
- 结肠直肠外科手术是什么意思
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 解剖管狭窄症使多达30%的结直肠切除复杂化.
- 有限的证据存在于风险因素和预防措施对静管狭窄.
研究的目的:
- 为了识别与结直肠和结直肠门静脉狭窄相关的技术风险因素.
- 为结直肠外科手术中的预防策略提供证据.
主要方法:
- 追溯队列研究,比较患有和没有静脉狭窄症的患者.
- 在100名接受结肠直肠切除或重复解剖的患者中分析技术因素.
- 收录标准:2011年1月至2021年8月,第三级推中心.
主要成果:
- 脊髓曲动员,较高的下层中枢动脉/静脉结合,显著降低了收缩风险 (HR < 0.22).
- 使用25毫米圆形接器,动静脉泄漏,多次接器发射和转移口腔的使用增加了狭窄风险 (HR>3.08).
- 两组在年龄,性别,ASA分数和距离牙线的距离方面都相似.
结论:
- 如果不能动员脏曲并执行中腔血管的高结合,则会增加解静管狭窄的风险.
- 小直径 (25毫米) 合器和多重合器发烧与较高的收缩率有关.
- 建议进行常规的 flexure 动员,高 mesenteric 血管的绑定,并避免特定的带技术.
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