在患有直肠形的患者中,结直肠术并发症
Tobias Klein1,2, Gloria Stephany Guarnizo-Diaz3, Alexander Semaan4
1Department of Pediatric and Adolescent Surgery and Pediatric Urology, Children's Hospital of Cologne, Kliniken der Stadt Köln gGmbH, Amsterdamer Straße 59, 50735, Cologne, Germany. 7081.klein@gmail.com.
Langenbeck's archives of surgery
|July 2, 2025
概括
在患有直肠形 (ARM) 的儿童中,结肠直肠术的并发症率很高. 与远端结肠切除相比,近端结肠切除减少了并发症和错位,简化了未来的正手术.
科学领域:
- 儿科手术 儿科手术
- 胃肠病学 胃肠病学
- 医疗器械技术 医疗器械技术
背景情况:
- 在儿科患者中,直肠形 (ARM) 经常需要进行保护性结肠直肠切除术.
- 最佳的结肠直肠术类型和放置仍然是争论的主题,影响患者的治疗结果.
- 对于ARM管理的有限专业知识可能会加剧创建和护理口腔门的挑战.
研究的目的:
- 评估ARM儿童结肠静脉错位和相关并发症的发生率.
- 为了比较并发症率和修订需求,根据结肠静脉瘤类型和解剖位置.
- 确定影响小儿ARM病例中与静脉管相关的发病率的因素.
主要方法:
- 在2005年至2019年期间接受治疗的276名ARM儿童的医疗记录的回顾性审查.
- 分析静脉瘤并发症,包括落和化,以及结肠静脉瘤修复率.
- 对近端与远端,循环与分割结肠切除术之间的结果进行比较.
主要成果:
- 总体而言,与静脉关联的并发症发生在23.6%的患者中,最常见的是落 (8.3%) 和化 (4.0%).
- 近端结肠切除术 (20.2%) 和循环口腔切除术 (21.0%) 的并发症率明显低于远端口腔切除术 (32.9%) 和分口口腔切除术 (37.2%).
- 在39.4%的病例中,远端结肠直肠切除需要检查错位,而近端结肠直肠切除没有 (p < 0.0001).
结论:
- 儿科ARM患者的结肠直肠术与相当大的整体并发症率有关.
- 结肠切除术的远部位置不正确,使后续的重建性手术复杂化.
- 靠近结肠静脉的放置与较少的并发症和修订有关,改善了手术结果.
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