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在结肠直肠手术后的早期与晚期严重的门泄漏失败:基于人口的多中心研究

Marie T Grönroos-Korhonen^1,2, Laura Koskenvuo¹, Panu J Mentula¹

¹Gastroenterological Surgery, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.

Annals of surgery

|August 4, 2025

概括

结直肠外科手术后严重的门泄漏 (AL) 的救援失败率在紧急情况下和晚发生的泄漏时更高. 关键的风险因素包括晚年和并发症,影响患者的治疗结果.

科学领域:

结肠直肠手术结肠直肠手术
手术并发症手术并发症
患者的治疗结果.

背景情况:

严重的静脉漏 (AL) 是需要重新手术的C级并发症,在结肠直肠手术中存在显著的死亡风险.
根据发生情况,AL被分为早期 (EAL) 和晚期 (LAL),影响患者的预后.

研究的目的:

评估和比较严重的早期和晚期道泄漏 (EAL和LAL) 的失败救援 (FTR) 率.
分析FTR与AL的时间和初始结直肠手术的紧迫性 (可选与紧急) 相比.

主要方法:

一项基于人口的,回顾性,多中心队列研究,针对接受结直肠手术 (2006-2017年) 的严重AL成年患者.
FTR被定义为重新手术后90天的死亡率;EAL和LAL通过术后第6天的截止时间进行区分.

主要成果:

严重的AL发生在8,562名患者中的3.3% (EAL:2.0%,LAL:1.3%).
总体而言,EAL的FTR率为13.7%,LAL的20.0%.
在紧急 vs 选择性手术 (29.1% vs 10.7%) 和在选择性手术后的LAL vs EAL (17.6% vs 7.0%) 中,FTR显著更高.
FTR的独立风险因素包括年龄>80,BMI <20 kg/m2,长时间的手术时间和先前的并发症.

结论:

在严重的静脉疏通泄漏后,失败救援率受到泄漏的时间发生 (早期或晚期) 和初级结直肠手术的紧急性显著影响.
这些发现突出了影响严重AL后患者生存的关键因素,为临床管理策略提供了信息.

关键词:

急性护理急性护理急性护理结肠结肠结肠结肠是什么意思并发症可能导致并发症.紧急情况紧急情况致命的致命的致命的致命的死亡率死亡率

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