除尾切除外:急性尾炎成年患者主要切除的预测因素
Manuela Monrabal Lezama1, María Gracia Álvarez Jurado1, Camila Bras Harriott1
1Department of Surgery, Hospital Alemán of Buenos Aires, Buenos Aire, Argentina.
World journal of surgery
|May 19, 2025
概括
急性尾炎的主要切除,涉及比标准腹腔镜尾切除 (LA) 更广泛的手术,与增加的并发症和更长的住院时间有关. 识别CT扫描结果等预测因素可以改善这些复杂病例的手术规划.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 腹部外科手术 腹部外科手术
背景情况:
- 急性尾炎可能需要比标准尾切除外的广泛手术干预.
- 在腹腔镜尾切除术 (LA) 中预测需要大切除 (MR) 的因素的识别对于患者管理至关重要.
- 了解急性尾炎中MR的外科结果对于临床实践至关重要.
研究的目的:
- 在经过腹腔镜尾切除术 (LA) 的患者中确定主要切除 (MR) 的预测因素.
- 为了确定与急性尾炎中MR相关的外科结果.
- 为了提高复杂尾炎病例的手术规划和患者咨询.
主要方法:
- 对从2006年到2023年接受LA的成年患者 (>16岁) 的回顾性分析.
- 队列被分为只有LA和MR组 (部分切除术,骨髓切除术或右侧切除术).
- 多变量逻辑回归用于识别MR的独立风险因素.
主要成果:
- 患者年龄较大,肥胖率较高,症状与咨询间隔较长.
- 在MR患者中,CT检测出肺关节,自由腹液和壁加厚的情况更为频繁.
- MR 与转换为开放手术的更高率,整体发病率,严重并发症 (Clavien III-IV) 和更长的住院时间有关.
结论:
- 与标准LA相比,急性尾炎的主要切除与明显更高的发病率有关.
- 临床和成像预测因素,如CT发现,可以帮助预测MR的需要.
- 识别这些预测因素可以改善手术规划,并告知患者增加的风险.
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