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结肠清洗是左侧结肠瘤紧急情况的有效工具吗?

Silvia Strambi¹, Francesco Giudice¹, Camilla Cremonini¹

¹Emergency and General Surgery Unit, New Santa Chiara Hospital, University of Pisa, Via Paradisa, 2, Pisa, 56021, Italy.

|December 30, 2025

概括

术内结肠清洗 (IOCL) 可以减少重症监护室 (ICU) 在急诊左侧结肠手术中的停留时间. 然而,与手动解压 (MD) 相比,它没有显示出与手动解压 (MD) 相比,道泄漏或手术部位感染的显著差异.

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:

管理左侧结肠瘤紧急情况在控制便污染和尽量减少手术风险方面存在挑战.
在手术内结肠清洗 (IOCL) 和手动解压 (MD) 之间进行选择,以应急左侧结肠切除与初级解剖是关键考虑因素.

研究的目的:

评估IOCL与MD在紧急左侧结肠切除中的疗效.
为了比较两种方法之间的道泄漏率,手术部位感染 (SSI),整体发病率和住院时间 (LOS).

主要方法:

在2010年至2022年期间,对70名接受紧急结直肠手术的患者进行了回顾性研究.
患者被分为IOCL (A组,n=23) 和MD (B组,n=47) 组.
主要终点: 解静脉泄漏率. 二级终点:切口SSI,整体发病率,死亡率和LOS.

主要成果:

IOCL显著增加了操作时间 (p<0.0001),但减少了ICU停留时间 (p<0.0001).
在IOCL和MD组之间,在道泄漏,切口SSI率,整体发病率或LOS方面没有发现显著差异.
研究结果表明,IOCL可能有利于选择的血液动力学稳定的患者,但与MD相比,IOCL不会显著影响整体发病率或感染风险.

结论:

对于接受紧急左侧结肠手术的特定患者,IOCL可能在减少ICU停留时间方面具有优势.
由于患病率和感染率相似,手动减压仍然是一个可行的替代方案.
需要进一步的多中心随机研究,以确定IOCL在常规实践中的最终临床益处和指导方针.

关键词:

解剖器的泄漏情况结肠结肠结肠结肠在外科手术期间进行洗.癌症紧急情况癌症紧急情况

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