非恶性左结肠急诊手术:评估影响临床效果和并发症的因素。

M. Çiftçi, Burak Uçaner, M. Buldanlı
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引用次数: 0

摘要

背景急诊结直肠切除术在普通外科手术中占有重要地位,而左侧结肠的病变相对常见。本研究以临床病理和生化数据为基础,评估了良性病因的孤立左结肠手术的结果。方法我们对 2017 年 1 月至 2022 年 1 月期间在一家三级医院普外科门诊接受左结肠手术的患者的人口统计学、临床和实验室数据进行了回顾性回顾和统计分析,其中不包括恶性肿瘤相关急诊患者。结果研究中 48 名患者的平均年龄为(56.9±16.4)岁。并发急性憩室炎是最常见的急诊手术指征(19 人,占 39.6%)。哈特曼手术是最常采用的手术技术(30 人,62.5%)。术后 30 天内的发病率和死亡率分别为 27.1% 和 8.3%。术后发病率增加与高龄(平均 65.4±15.8 对 53.8±15.7,P=0.028)、术前使用血管加压剂、血小板计数较低、低白蛋白血症(20 mg/dl)有关。结论 对于与左侧结肠病变有关的急诊结直肠手术,在围手术期进行全面评估至关重要,尤其是对于老年患者、肾功能异常的低血压患者以及需要使用血管加压药的患者。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Non-malignant left colon emergency surgery: evaluation of factors affecting clinical outcomes and complications.
BACKGROUND Emergency colorectal resections hold a significant position in general surgical practice, and pathologies of the left colon are relatively common. This study was conducted to assess the outcomes of isolated left colon surgeries with benign etiologies, drawing on clinicopathological and biochemical data. METHODS We carried out a retrospective review and statistical analysis of demographic, clinical, and laboratory data of patients who underwent left colon surgery at the general surgery clinic of a tertiary care hospital, excluding those with malignancy-related emergencies, from January 2017 to January 2022. RESULTS The average age of the 48 patients in the study was 56.9±16.4 years. Complicated acute diverticulitis was the most frequent indication for emergency surgery (n=19, 39.6%). The Hartmann procedure was the surgical technique most often employed (n=30, 62.5%). The rates of postoperative morbidity and mortality within 30 days were 27.1% and 8.3%, respectively. Increased postoperative morbidity was linked to advanced age (mean 65.4±15.8 vs. 53.8±15.7, p=0.028), the preoperative administration of vasopressors, lower platelet counts, hypoalbuminemia (<3 mg/dl), and azotemia (blood urea nitrogen >20 mg/dl). There was no statistically significant correlation between comorbidities, American Society of Anesthesiologists (ASA) scores, surgical methods, or other clinical data and postoperative outcomes. CONCLUSION For emergency colorectal surgery pertaining to left colon pathologies, it is critical to conduct a comprehensive evaluation in the perioperative period, especially for elderly and hypotensive patients with renal function abnormalities and for those requiring vasopressors.
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