门诊腹腔镜直肠外科手术管理范式与初始经验:一个潜在的随机临床试验
Zhi Zhu1, Ziming Gao1, Xinwei Zhang1
1Department of Surgical Oncology, The First Hospital of China Medical University, Shenyang, China.
International journal of surgery (London, England)
|December 17, 2025
概括
门诊性结肠直肠手术 (ACS) 是可行的和安全的,尽管住院时间显著缩短,但其并发症率与传统的住院护理相当. 这种方法为结直肠癌治疗提供了一个有希望的替代方案.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 手术瘤学手术瘤学
- 最少侵入性手术的方法
背景情况:
- 评估大肠直肠癌门诊手术的可行性和安全性.
- 评估影响出行直肠外科手术推广和应用的因素.
- 提供基于证据的数据,用于采用门诊结直肠外科手术.
研究的目的:
- 评估门诊直肠外科手术 (ACS) 的可行性和安全性.
- 为了比较ACS和传统结直肠手术 (TCS) 之间的30天病率.
- 确定影响ACS成功实施的因素.
主要方法:
- 一项随机临床试验比较ACS (具有24小时出院协议的最小侵入性手术) 和TCS (传统住院护理).
- 有148名符合条件的患者被随机分为1:1.
- 主要结局是30天的发病率,包括再入院,重复手术,静脉漏,大肠和感染.
主要成果:
- 在ACS (7.7%) 和TCS (8.5%) 组之间30天的发病率没有显著差异 (P=0.87).
- ACS患者的住院时间显著缩短 (17.8 vs 109.6小时,P<0.001),96.9%的患者在24小时内出院.
- 再录取率相似 (6.2%对5.6%),两组都没有死亡率.
结论:
- 门诊性结直肠手术是初步可行的和安全的.
- 在ACS中,并发症的发生率与传统的住院治疗相当,住院时间明显较短.
- 需要进一步的招生来验证研究结果,并澄清ACS的影响因素.
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