Ming Duan, Lei Cao, Mengjie Lu, Tenghui Zhang, Qing Ji, Xian Guo, Zhen Guo, Qiong Wu, Yuxiu Liu, Jianfeng Gong, Weiming Zhu, Yi Li
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引用次数: 0
摘要
背景：预防性术中引流被证明对接受肠道手术的患者没有优势。然而，对于克罗恩病（CD）患者来说，这一点还需要进一步探讨：在这项试验性研究中，克罗恩病患者被随机分配到引流管组（50 人）和无引流管组（50 人）。主要终点是术后回肠延长率（PPOI）。次要终点是术后腹水、术后全身炎症反应综合征（SIRS）和 C 反应蛋白（CRP）水平：结果：引流管组的 PPOI 和术后腹水发生率明显较低（12% 对 44%；0% 对 24%，均 P < .05）。无引流组的术后 SIRS 发生率和 CRP 水平明显升高 [36% vs 10%; 54.9 vs 34.3 mg/L，均 P < .05]。在多变量分析中，预防性引流是 PPOI 和术后 LOS 的独立保护因素：结论：预防性引流可改善 CD 患者的临床预后。
Prophylactic Intra-abdominal Drainage is Associated With Lower Postoperative Complications in Patients With Crohn's Disease: A Randomized Controlled Trial.
Background: Prophylactic intraoperative drains have been shown not superior for patients underwent intestinal surgery. However, for patients with Crohn's disease (CD), this needs further exploration.
Methods: In this pilot study, CD patients were randomly assigned to drain (n = 50) and no-drain (n = 50) groups. The primary endpoint was the rate of postoperative prolonged ileus (PPOI). The secondary endpoints were postoperative abdominal ascites, postoperative systemic inflammatory response syndrome (SIRS) and C-reactive protein (CRP) levels.
Results: The incidences of PPOI and postoperative abdominal ascites were significantly lower in the drain group (12% vs 44%; 0% vs 24%, both P < .05). Postoperative SIRS incidence and CRP levels were significantly increased in the no-drain group [36% vs 10%; 54.9 vs 34.3 mg/L, both P < .05]. In multivariate analysis, prophylactic drainage was the independent protective factor for PPOI and postoperative LOS.
Conclusions: Prophylactic drainage may be associated with improved clinical outcomes in CD patients.
期刊介绍：
Surgical Innovation (SRI) is a peer-reviewed bi-monthly journal focusing on minimally invasive surgical techniques, new instruments such as laparoscopes and endoscopes, and new technologies. SRI prepares surgeons to think and work in "the operating room of the future" through learning new techniques, understanding and adapting to new technologies, maintaining surgical competencies, and applying surgical outcomes data to their practices. This journal is a member of the Committee on Publication Ethics (COPE).
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