吲哚菁绿荧光血管造影术(ICG-FA)在腹部穿透性创伤后肠道损伤治疗中的应用:一项比较术后结果的病例对照研究。

IF 12.5 2区 医学 Q1 SURGERY
Mohamed Q Patel, Jens Tf Osterkamp, Johan Jp Buitendag, Timothy R Forgan, Elmin Steyn
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引用次数: 0

摘要

背景:穿透性空腔内脏损伤的手术治疗包括初级修复或外部处理。胃肠道缝合修复部位的组织灌注情况可能难以评估,而且很容易因各种原因造成局部能量转移相关损伤、微循环或大循环不足或脾血管收缩。缝合线断裂可能导致危及生命的并发症。术中使用吲哚菁绿荧光血管造影术(ICG-FA)可确保所选缝合修复部位的最佳组织灌注,从而降低术后发病率和死亡率:我们对南非开普敦一家一级创伤中心的腹部穿透性创伤开腹手术患者的术后并发症、重症监护室(ICU)住院时间和住院时间进行了回顾性研究:研究共纳入了 100 名患者,其中 20 人接受了带有 ICG-FA 的开腹手术,80 人未接受开腹手术。ICG-FA 组的总体并发症发生率明显较低(OR 0.336,P 值=0.0412)。ICG-FA 组和对照组的吻合口漏率分别为 0% 和 6.25%(P 值=0.5799)。ICG-FA 组和对照组分别有 2 名和 14 名患者需要进行翻修手术(OR 0.524,P 值=0.516)。ICG-FA组和对照组的平均住院时间没有统计学差异,分别为8.6天和5.3天(P值=0.092)。ICG-FA 组和对照组的 ICU 平均住院时间分别为 6.3 天和 2.3 天(P 值=0.1642):结论:使用 ICG-FA 进行开腹手术的患者术后总体并发症水平较低,翻修手术率也较低,前景看好。ICG-FA 的使用与吻合口漏发生率之间关系的非显著性结果表明,需要进行更大规模的随机研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Indocyanine Green Fluorescence Angiography (ICG-FA) in the management of intestinal injuries following penetrating abdominal trauma: a case-control study comparing postoperative outcomes.

Background: The surgical management of penetrating hollow visceral injuries includes primary repair or exteriorization. Tissue perfusion at the site of gastrointestinal suture repair may be challenging to assess and is vulnerable to local energy transfer-related injury, micro- or macro-circulatory insufficiency, or splanchnic vasoconstriction for various reasons. Breakdown of suture lines can lead to potentially life-threatening complications. The intraoperative use of Indocyanine Green Fluorescence Angiography (ICG-FA) may reduce the risk of postoperative morbidity and mortality by ensuring optimal tissue perfusion at the chosen site of suture repair.

Materials and methods: We conducted a retrospective review of the postoperative complications, length of Intensive Care (ICU) stay, and length of hospital stay in patients undergoing laparotomy, with and without ICG-FA for penetrating abdominal trauma at a Level One Trauma Center in Cape Town, South Africa.

Results: One hundred patients were included in the study, of which 20 underwent laparotomy with ICG-FA, and 80 did not. The overall complication rate was significantly lower in the ICG-FA group (OR 0.336, p-value=0.0412). The anastomotic leak rates in the ICG-FA and control groups were 0% and 6.25%, respectively (p-value=0.5799). Revision surgery was required in 2 and 14 patients in the ICG-FA and control groups, respectively (OR 0.524, p-value=0.516). The mean length of stay in hospital showed no statistical difference, 8.6 and 5.3 days for the ICG-FA and control groups, respectively (p-value=0.092). The mean length of ICU stay was 6.3 and 2.3 days for the ICG-FA and control groups, respectively (p-value=0.1642).

Conclusion: Lower levels of overall postoperative complications and lower rates of revision surgery in patients undergoing laparotomy with ICG-FA are promising. Non-significant findings regarding the relationship between the usage of ICG-FA and anastomotic leak rates suggest the need for larger randomized studies.

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来源期刊
CiteScore
17.70
自引率
3.30%
发文量
0
审稿时长
6-12 weeks
期刊介绍: The International Journal of Surgery (IJS) has a broad scope, encompassing all surgical specialties. Its primary objective is to facilitate the exchange of crucial ideas and lines of thought between and across these specialties.By doing so, the journal aims to counter the growing trend of increasing sub-specialization, which can result in "tunnel-vision" and the isolation of significant surgical advancements within specific specialties.
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