造口术取出时的体重是手术时间的考虑因素之一--这有关系吗?

IF 1.1 4区 医学 Q3 SURGERY
Goeto Dantes, Jack Murfee, Alissa Doll, Katrina Weaver, Hanna Alemayehu
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引用次数: 0

摘要

目的:体重阈值历来决定着早产新生儿肠造口术(EC)的时机。最近的证据表明,体重小于 2 千克(L2K)的新生儿可以安全地进行肠造口术。我们评估了单中心在 L2K 与体重大于 2 kg (G2K) 的早产新生儿进行肠造口术时的经验。方法:我们对 2018 年 1 月至 2020 年期间接受 EC 的新生儿进行了回顾性审查。排除了初次手术时超过 90 天的新生儿。我们回顾了人口统计学、临床特征(包括胎龄(GA)和出生体重(BW))、手术报告和结果。我们比较了在 L2K 和 G2K 接受 EC 手术的新生儿 30 天内的并发症情况。我们还比较了完全进食时间(FF)和术后住院时间(LOS)。结果:共纳入 24 名新生儿:11 名 L2K 和 13 名 G2K。GA和体重的中位数分别为25.9周(IQR 2.89)和805克(IQR 327)。索引手术中最常见的术中诊断是自发性穿孔(70%),其次是坏死性小肠结肠炎(8.69%)。L2K 组群与 G2K 组群在血容量、体重或诊断方面没有明显差异。我们发现,在 L2K 和 G2K 接受 EC 的患者在并发症发生率、FF 时间(12 天对 10 天,P = .89)或术后 LOS(31 天对 36.5 天,P = .76)方面分别没有差异。结论:虽然体重增加可能是围手术期营养状况的一个重要指标,但本研究表明,不能仅凭体重就排除其他合适的患者接受 EC。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Weight at Ostomy Takedown as a Factor to Consider for Operative Timing-Is It Relevant?

Purpose: Weight thresholds have historically determined timing of enterostomy closure (EC) in premature neonates. Recent evidence suggests that neonates less than 2 kg (L2K) can safely undergo EC. We evaluate our single-center experience with performing EC in preterm neonates at L2K versus greater than 2 kg (G2K) at time of EC. Methods: A retrospective review of neonates who underwent EC from January 2018 to 2020 was performed. Neonates who were greater than 90 days at initial operation were excluded. Demographics, clinical characteristics including gestational age (GA) and birth weight (BW), operative reports, and outcomes were reviewed. We compared 30-day complications between neonates who underwent EC at L2K and G2K. We also compared time to full feeds (FF) and postoperative length of stay (LOS). Results: Twenty-four neonates were included: 11 L2K and 13 G2K. The median GA and BW was 25.9 weeks (IQR 2.89) and 805 g (IQR 327), respectively. The most common intraoperative diagnosis during index operation was spontaneous perforation (70%), followed by necrotizing enterocolitis (8.69%). There were no significant differences in GA, BW, or diagnosis, between the L2K versus G2K cohort. We found no difference in complication rates, time to FF (12 days versus 10 days, P = .89), or postoperative LOS (31 days versus 36.5 days, P = .76) between patients who underwent EC at L2K versus G2K, respectively. Conclusion: Although weight gain may be an important indicator of perioperative nutrition status, this study shows that weight alone should not preclude otherwise appropriate patients from undergoing EC.

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来源期刊
CiteScore
2.90
自引率
0.00%
发文量
163
审稿时长
3 months
期刊介绍: Journal of Laparoendoscopic & Advanced Surgical Techniques (JLAST) is the leading international peer-reviewed journal for practicing surgeons who want to keep up with the latest thinking and advanced surgical technologies in laparoscopy, endoscopy, NOTES, and robotics. The Journal is ideally suited to surgeons who are early adopters of new technology and techniques. Recognizing that many new technologies and techniques have significant overlap with several surgical specialties, JLAST is the first journal to focus on these topics both in general and pediatric surgery, and includes other surgical subspecialties such as: urology, gynecologic surgery, thoracic surgery, and more.
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