食道切除术后的质泄漏:"三级医疗中心的回顾性10年单位体验"
Paul Koroma1, Madhu Chaudhury1, Vinutha Shetty1
1Department of Upper GI Surgery, Lancashire Teaching Hospitals NHS Foundation Trust, Royal Preston Hospital, Fulwood, Sharoe Green Lane, Fulwood, Preston, Lancashire, PR2 9HT, UK.
概括
胃肠切除术后的性泄漏,是一种罕见的并发症,发生在4.4%的患者中. 对大体积泄漏的手术干预是安全有效的,减少死亡率和住院时间,而保守的管理适合低体积病例.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 胸部外科手术 胸部外科手术
背景情况:
- 胃肠切除术后的胆漏是一种罕见但严重的并发症,报告的死亡率很高.
- 管理漏需要专门的专业知识,特别是在三级癌症中心.
研究的目的:
- 在第三级食管胃癌中心评估食管切除术后性泄漏的发生率和管理策略.
- 为了分析术后食道切除术后胆泄漏的外科手术与保守治疗的结果.
主要方法:
- 在2009年至2019年期间,对550名接受选择性食道切除术的患者进行了回顾性分析.
- 从电子数据库中收集的数据,包括发病率,管理,停留时间和死亡率.
- 使用曼-惠特尼U测试对非正常分布数据进行统计分析.
主要成果:
- 在24名患者 (4.4%) 中发生了酸泄漏,所有患者都接受了新辅助化疗和开放的艾沃尔·易斯食道切除术.
- 手术管理 (n=20) 的中位停留时间为20天,死亡率为5%.
- 保守管理 (n=4) 的中位停留时间为31天,死亡率为0%.
结论:
- 早期手术对大体积漏的干预是安全的,有效的,并减少死亡率和停留时间.
- 保守的管理是适合低体积的气泄漏或那些响应医疗治疗的人.
- 通过适当的手术干预,可以实现低漏死亡率.
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