在直肠切除后转向乳房切除术的早期关闭:我们是否准备好进行转变?
1Department of Surgery, College of Medicine, Imam Abdulrahman Bin Faisal University, Dammam, Saudi Arabia.
概括
在直肠癌手术后,早期结肠静脉关闭可能会减少特定患者的静脉静脉关闭并发症. 然而,感染的风险意味着它.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 对直肠癌进行低前切除后,转向静脉切除是标准的,以防止静脉切除的泄漏.
- 延迟的静脉切口关闭与与静脉切口相关的发病率和潜在的永久转移有关.
- 逆转骨髓切除术的最佳时间仍然是一个重要的临床问题.
研究的目的:
- 审查随机对照试验 (RCT) 和关于早期结节管关闭的元分析的证据.
- 评估早期结节切开术逆转的安全性和结果.
- 为了确定早些时候的逆转是否对选择的直肠癌患者是合理的.
主要方法:
- 进行了出版文献的叙事审查.
- 包括随机试验,前性研究和系统审查.
- 搜索的数据库:PubMed,Scopus和谷歌学者.
- 专注于外科手术期间的发病率,口腔静脉瘤并发症,生活质量和功能结果.
主要成果:
- 随机试验结果各不相同:有些人支持早期关闭,减少静脉关口并发症,而另一些人则报告感染和伤病率增加.
- 分析表明,早期关闭减少了口腔的并发症,但增加了伤口感染;整体发病率相似.
- 患者选择,解剖管完整性和瘤治疗是影响结果的关键因素.
- 回顾性数据表明,成本效益和生活质量方面的好处是可预见的.
结论:
- 在经过精心挑选的患者中,早期静脉切除术的关闭是可行的和安全的,可以减少静脉切除术的负担,而不会影响癌症治疗.
- 由于在未经选择的人群中存在持续的风险,目前还不建议进行常规的早期关闭.
- 为了指导临床实践,需要进一步的多中心RCT,采用标准化方案和长期终点.
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