Steven D. Gurien, P. Chung, C. Nofi, G. Coppa, G. Sugiyama
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引用次数: 0
摘要
背景:终末期肾脏疾病(ESRD)患者需要普通外科手术的患病率正在增加。我们的目的是探讨ESRD对选择性腹腔镜腹疝修补术患者的影响。方法:使用美国外科医师学会国家手术质量改进计划(2010-2015)数据库来识别接受择期腹腔镜腹疝修补术的患者。进行多变量分析,调整包括年龄、性别、种族、合并症状况、体重指数≥35和是否存在ESRD等风险变量。结果:择期腹腔镜腹疝修补术共8789例。64例(0.73%)发生ESRD。ESRD被确定为术后肺炎(比值比[OR] 6.91, p = 0.00363)、脓毒症(OR 18.58, p = 0.000286)和住院时间(IRR 1.63, 95%可信区间1.19 - 2.27,p = 0.0036)的独立危险因素。结论:接受选择性腹腔镜腹疝修补术的ESRD患者术后肺炎、败血症和住院时间的风险增加。临床医生在对ESRD患者进行选择性手术时应认识到这些风险。
Laparoscopic Ventral Hernia Repair Postoperative Complications in End Stage Renal Disease Patients
Background: The prevalence of patients with end stage renal disease (ESRD) requiring general surgical procedures is increasing. Our aim was to explore the effect of ESRD on patients undergoing elective laparoscopic ventral hernia repair. Methods: The American College of Surgeons National Surgical Quality Improvement Program (2010–2015) database was used to identify patients who underwent elective laparoscopic ventral hernia repair. Multivariable analysis was performed adjusting for risk variables including age, gender, race, comorbidity status, body mass index ≥ 35, and presence of ESRD. Results: A total of 8,789 patients undergoing elective laparoscopic ventral hernia repair were identified. Sixty-four patients (0.73%) had ESRD. ESRD was identified as an independent risk factor for postoperative pneumonia (odds ration [OR] 6.91, p = 0.00363), sepsis (OR 18.58, p = 0.000286), and length of stay (IRR 1.63, 95% confidence interval 1.19 – 2.27, p = 0.0036). Conclusions: ESRD patients undergoing elective laparoscopic ventral hernia repair had an increased risk of postoperative pneumonia, sepsis, and length of stay. Clinicians should be cognizant of these risks when performing elective operations on ESRD patients.