胰十二指肠切除术胰消化吻合术的优化引流

N. Mena, Polina Marinova-Kichikova, K. Kirov
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引用次数: 0

摘要

本研究比较两组胰十二指肠切除术治疗胰头癌患者的早期术后并发症:胰胃吻合混合引流组与胰空肠吻合外引流组对照。本研究为队列研究。前瞻性选择患者组,回顾性选择对照组。患者按性别、年龄、原发肿瘤部位、胰腺实质密度、临床症状、肿瘤淋巴结转移(TNM)和分级(G)随机分组。我们使用IBM SPSS统计软件进行以下检验:Fisher精确检验、Pearson卡方检验、Mann-Whitney U检验。优化的混合引流重建方法减少了早期并发症:早期死亡率- 2.5%,总发病率- 7.5%;胰消化吻合功能不全-减少2.5%;腹腔内出血-减少2.5%;腹腔内感染-减少2.5%;胃轻瘫- 5.0%;伤口感染-减少2.5%;胆道渗漏-减少2.5%。无临床意义的胰瘘病例。对照组出现早期并发症的相对风险平均高出9倍。通道在第4天到第7天之间被修复。患者的平均住院时间(11天)比对照组(22天)短。单袢消化道吻合器重建和改良鼻胃管混合腔内引流使术后早期并发症减少7倍,住院时间缩短2倍。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Optimized Drainage of Pancreatic-Digestive Anastomosis in Patients with Pancreatoduodenal Resection
Summary The study compared early post-surgical complications between two groups of patients with pancreatoduodenal resection for pancreatic head carcinoma: patients with pancreatic-gastric anastomosis with mixed drainage and controls with pancreatic jejunal anastomosis with external drainage. The present study was a cohort study. The patient group was selected prospectively, and the control group – retrospectively. Patients were randomized by sex, age, primary tumor location, pancreatic parenchyma density, clinical symptoms, tumor–node–metastasis (TNM), and grade (G). We used the IBM SPSS Statistics software with the following tests: Fisher’s exact test, Pearson’s chi-squared test, Mann–Whitney U test. The optimized reconstruction approach with mixed drainage reduced early complications: early mortality - by 2.5%, overall morbidity - by 7.5%; pancreatic-digestive anastomosis insufficiency - by 2.5%; intra-abdominal bleeding - by 2.5%; intra-abdominal infection - by 2.5%; gastroparesis - by 5.0%; wound infection - by 2.5%; biliary leakage -by 2.5%. There were no cases of clinically significant pancreatic fistula. The control group was associated with an average of 9-fold higher relative risk of early complications. The passage was restored between the 4th and 7th day. Patients had a shorter average hospital stay (11 days) compared to controls (22 days). Digestive anastomoses reconstruction on a single loop and mixed intraluminal drainage through a modified nasogastric tube led to a 7-fold reduction in early post-surgical complications and a 2-fold shorter hospital stay.
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