Kristina H-T La, Yosef Y Nasseri, Rachel Ma, Vincent Xu, Paola Solís Pazmiño, Abbas Smiley, Joshua Ellenhorn, Sean Langenfeld, Robert Bergamaschi, Moshe Barnajian
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引用次数: 0
摘要
我们的目的是研究微创选择性结肠切除术患者围手术期输血与术后肠梗阻的关系。这是一项使用2016-2020年美国外科医师学会国家手术质量改进计划(ACS-NSQIP)数据库的回顾性研究。选择接受选择性腹腔镜或机器人结肠切除术的结肠癌患者。围手术期输血被定义为在手术开始后72小时内接受一个或多个单位的全红细胞/包装红细胞。采用多变量logistic回归并反向消除,分析合并症,术中和术后变量,以确定术后肠梗阻的危险因素。纳入48728例患者,平均年龄64.7岁,男性52.3%,平均BMI为28.8 kg/m2。总体而言,男性的肠梗阻发生率高于女性(分别为13%和7.6%,P = 0.0001)。机器人手术和腹腔镜手术后肠梗阻发生率无差异(分别为10.4%和10.4%,P = 0.8)。在2960例接受输血的患者中,516例(17.4%)发生肠梗阻,而在45,768例未接受输血的患者中,4569例(10.0%)发生肠梗阻(P = 0.0001)。在多变量logistic回归分析中,输血患者发生肠梗阻的可能性是输血患者的1.37倍(95% CI 1.2-1.5, P = 0.0001)。围手术期输血是癌症微创结肠切除术后肠梗阻的独立危险因素。
Perioperative blood transfusion is an independent risk factor for ileus following minimally invasive elective colectomy for cancer.
We aim to investigate the correlation between perioperative blood transfusion and postoperative ileus in patients who have undergone minimally invasive elective colectomy for cancer. This is a retrospective study using the 2016-2020 American College of Surgeons National Surgical Quality Improvement Program (ACS-NSQIP) database. Patients with colon cancer who underwent elective laparoscopic or robotic colectomy were selected. Perioperative transfusion was defined as receiving one or more units of whole/packed RBCs within 72 h of onset of operation. Using multivariable logistic regression with backward elimination, comorbidities, and intraoperative and postoperative variables were analyzed to identify risk factors for postoperative ileus. 48,728 patients were included with a mean age of 64.7 years, 52.3% were males, and a mean BMI of 28.8 kg/m2. Overall, men had a higher rate of ileus than women (13 and 7.6%, respectively, P = 0.0001). There was no difference in rates of ileus following robotic and laparoscopic surgery (10.4 and 10.4%, respectively, P = 0.8). Of the 2960 patients who had a blood transfusion, 516 (17.4%) had an ileus, whereas of the 45,768 patients who did not have a blood transfusion, 4569 (10.0%) had an ileus (P = 0.0001). On multivariable logistic regression analysis, patients with blood transfusions were 1.37 times more likely to develop an ileus (95% CI 1.2-1.5, P = 0.0001). Perioperative blood transfusion is an independent risk factor for ileus following minimally invasive colectomy for cancer.
期刊介绍:
Updates in Surgery (UPIS) has been founded in 2010 as the official journal of the Italian Society of Surgery. It’s an international, English-language, peer-reviewed journal dedicated to the surgical sciences. Its main goal is to offer a valuable update on the most recent developments of those surgical techniques that are rapidly evolving, forcing the community of surgeons to a rigorous debate and a continuous refinement of standards of care. In this respect position papers on the mostly debated surgical approaches and accreditation criteria have been published and are welcome for the future.
Beside its focus on general surgery, the journal draws particular attention to cutting edge topics and emerging surgical fields that are publishing in monothematic issues guest edited by well-known experts.
Updates in Surgery has been considering various types of papers: editorials, comprehensive reviews, original studies and technical notes related to specific surgical procedures and techniques on liver, colorectal, gastric, pancreatic, robotic and bariatric surgery.