8年来新出现的副食道 Hernia 修复的国家趋势
Ashley Tran1, John C Lipham1, Sharon Shiraga1
1Division of Upper GI and General Surgery, Keck School of Medicine of USC, Los Angeles, CA, USA.
The American surgeon
|September 13, 2025
概括
从2015年到2022年,突发性准食道修复率 (emPEHR) 增加,突发病例显示出更高的并发症风险. 虽然一些并发症减少了,但积极的选择性修复仍然对准食道修复的更好的结果至关重要.
科学领域:
- 胃肠病学 胃肠病学
- 外科手术的结果
- 医疗保健服务研究 医疗服务研究
背景情况:
- 突发性准食道修复 (emPEHR) 是针对监禁或胃卷发等严重并发症进行的.
- 关于emPEHR不断变化的管理策略和结果的数据有限.
- 这项研究分析了八年来empEHR的国家趋势.
研究的目的:
- 评估患者人口统计,手术特征和empEHR的30天术后结果的国家趋势.
- 为了比较新兴和选择性准食道修复 (PEHR) 之间的结果.
主要方法:
- 利用了2015-2022年美国外科医生学院-国家外科质量改进计划 (ACS-NSQIP) 数据库.
- 使用当前程序术语 (CPT) 代码识别的emPEHR案件.
- 分析了患者特征,手术方法和术后结果的趋势.
主要成果:
- 总共有42,476个PEHR病例被确定,其中3.7%被归类为紧急.
- 发病例的比例显著增加,从2015年的3.1%增加到2022年的5.6% (P < 0.001).
- 与选择性病例相比,紧急病例的并发症,败血症,再手术,再入院和死亡率较高,尽管脏并发症和输血减少.
结论:
- 自2015年以来,emPEHR的速度显著增加.
- 新出现的PEHR与选择性修复相比,术后后果明显更差.
- 强调选择性修复副食道,并确定患者进行早期干预,对于改善整体患者的治疗结果至关重要.
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