在粘性小肠阻塞的腹腔镜方法中转换为开放手术:预测因素及其对短期结果的影响
Shengqiang Wang1, Dawei Zhang1, Hao Lu1
1Department of Emergency General Surgery, The Affiliated Hospital of Qingdao University, Qingdao, Shandong, China.
American journal of surgery
|March 22, 2025
概括
一个大的腹壁比率增加了转换腹腔镜手术的风险粘性小肠阻塞 (ASBO) 开放手术. 然而,在成像上存在特定的"标志"是保护性的,这表明更安全的腹腔镜方法.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 腹部外科手术 腹部外科手术
背景情况:
- 粘性小肠阻塞 (ASBO) 是一个频繁的手术紧急情况.
- 对于ASBO的腹腔镜治疗正在增长,但其精确的指示需要进一步定义.
- 确定转换为开放外科手术的预测因素对于优化腹腔镜ASBO治疗至关重要.
研究的目的:
- 确定与ASBO从腹腔镜转换为开放手术相关的风险因素.
- 评估转换对患者短期结局的影响.
- 为了澄清腹腔镜ASBO治疗的指示.
主要方法:
- 对102名ASBO患者进行初始腹腔镜手术的回顾性审查.
- 分类为完全腹腔镜 (n=43) 和转换为开放外科手术 (n=59) 组.
- 人口,临床和放射性特征的比较;为确定风险因素而进行单变量和多变量分析.
主要成果:
- 从家到入院的时间更长,腹壁比较大与转化有关.
- 较少的先前腹部手术和标志的存在与成功的腹腔镜方法有关.
- 转换组经历了更长的手术时间,增加了血液损失,增加了医疗费用,并延长了住院时间.
结论:
- 大的腹壁比率是转换到开放手术的独立风险因素.
- 在成像中存在标志是防止转换的保护因素.
- 从腹腔镜转换为ASBO的开放手术可以在适当管理指示时安全地进行.
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