术中结直肠吻合口瘘的诊断和处理:一项全球回顾性患者病历回顾研究。

Surgery Research and Practice Pub Date : 2017-01-01 Epub Date: 2017-06-14 DOI:10.1155/2017/3852731
A Schiff, S Roy, M Pignot, S K Ghosh, E J Fegelman
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引用次数: 12

摘要

背景:这项有针对性的图表回顾研究首次详细报道了常规临床实践中用于检测和处理手术中发现的吻合口瘘的临床方法。方法:来自8个国家的156名外科医生回顾性提取了458例术中发现环状吻合口漏的结直肠手术患者的手术记录。按国家对人口统计细节、程序和结果进行描述性分析。结果:以腹腔镜手术为主(57.6%),其次为开腹手术(35.8%)。术中泄漏给医疗系统带来的负担在很大程度上是由额外的干预措施造成的,如使用密封剂、重建吻合口、将吻合口转移到结肠造口袋中,这些措施都是为了控制泄漏。平均住院时间为19.9天。术后吻合口瘘62例(13.5%),多见于术后4 ~ 7天。总体而言,各国在患者特征、外科手术、术中泄漏诊断方法、干预措施和住院时间等方面存在差异。结论:手术中修复术中泄漏所需的潜在时间和材料成本是巨大的,而且往往被医疗保健系统所掩盖,这可能导致对该并发症影响的低估。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

Diagnosis and Management of Intraoperative Colorectal Anastomotic Leaks: A Global Retrospective Patient Chart Review Study.

Diagnosis and Management of Intraoperative Colorectal Anastomotic Leaks: A Global Retrospective Patient Chart Review Study.

Diagnosis and Management of Intraoperative Colorectal Anastomotic Leaks: A Global Retrospective Patient Chart Review Study.

Diagnosis and Management of Intraoperative Colorectal Anastomotic Leaks: A Global Retrospective Patient Chart Review Study.

Background: This targeted chart review study reports the first ever detailed global account of clinical approaches adopted to detect and manage anastomotic leaks identified during surgery in routine clinical practice.

Method: 156 surgeons from eight countries retrospectively extracted data from surgical records of 458 patients who underwent colorectal surgery with an identified intraoperative leak at the circular anastomosis. Demographic details, procedures, and outcomes were analyzed descriptively, by country.

Results: Most surgeries were performed laparoscopically (57.6%), followed by open surgeries (35.8%). The burden of intraoperative leaks on the healthcare system is driven in large part by the additional interventions such as using a sealant, recreating the anastomosis, and diverting the anastomosis to a colostomy bag, undertaken to manage the leak. The mean duration of hospitalization was 19.9 days. Postoperative anastomotic leaks occurred in 62 patients (13.5%), most frequently 4 to 7 days after surgery. Overall, country-specific differences were observed in patient characteristics, surgical procedures, method of diagnosis of intraoperative leak, interventions, and length of hospital stay.

Conclusion: The potential cost of time and material needed to repair intraoperative leaks during surgery is substantial and often hidden to the healthcare system, potentially leading to an underestimation of the impact of this complication.

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来源期刊
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发文量
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期刊介绍: Surgery Research and Practice is a peer-reviewed, Open Access journal that provides a forum for surgeons and the surgical research community. The journal publishes original research articles, review articles, and clinical studies focusing on clinical and laboratory research relevant to surgical practice and teaching, with an emphasis on findings directly affecting surgical management.
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