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首页> 外文期刊>World Journal of Gastroenterology >Factors determining delay in relaparotomy for anastomotic leakage after colorectal resection
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Factors determining delay in relaparotomy for anastomotic leakage after colorectal resection

机译：大肠切除术后再开腹吻合口漏延迟的因素

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AIM: To analyze the time interval ('delay') between the first occurrence of clinical parameters associated with anastomotic leakage after colorectal resection and subsequent reiaparotomy. METHODS: In 36 out of 289 consecutive patients with colorectal anastomosis, leakage was confirmed at relaparotomy. The medical records of these patients were retrospectively analysed and type and time of appearance of clinical parameters suggestive of anastomotic leakage were recorded. These parameters included heart rate, body temperature, local or generalized peritoneal reaction, leucocytosis, ileus and delayed gastric emptying. Factors influencing delay of relaparotomy and consequences of delayed recognition and treatment were determined. RESULTS: First documentation of at least one of the predefined parameters for anastomotic leakage was after a median interval of 4 ± 1.7 d after the operation. The median number of days between first parameter(s) associated with leakage and relaparotomy was 3.5 ± 5.7 d. The time interval between the first signs of leakage and relaparotomy was significantly longer when a weekend was included (4.2 d vs 2.4 d, P = 0.021) or radiological evaluation proved to be false-negative (8.1 d vs 3.5 d, P = 0.007). No significant association between delay and number of additional relaparotomies, hospital stay or mortality could be demonstrated. CONCLUSION: An intervening weekend and negative diagnostic imaging reports may contribute to a delay in diagnosis and relaparotomy for anastomotic leakage. That delay was more than two days in two-thirds of the patients.
机译：目的：分析大肠切除术后首次出现与吻合口漏相关的临床参数之间的时间间隔（“延迟”）。方法：在289例大肠吻合的连续患者中，有36例在再次开腹手术中证实有渗漏。回顾性分析这些患者的病历，并记录提示吻合口漏的临床参数的类型和出现时间。这些参数包括心率，体温，局部或全身性腹膜反应，白细胞增多，肠梗阻和胃排空延迟。确定了影响再开腹手术延迟的因素以及延迟识别和治疗的后果。结果：至少一个吻合口漏的预定参数的首次记录是在手术后的中位间隔4±1.7 d之后。与渗漏和再开腹相关的第一个参数之间的中位数天数为3.5±5.7 d。当包括一个周末时，漏出和再次开腹的最初迹象之间的时间间隔明显更长（4.2 d vs 2.4 d，P = 0.021）或放射学评估为假阴性（8.1 d vs 3.5 d，P = 0.007） 。延迟与再次手术的数量，住院时间或死亡率之间没有显着相关性。结论：周末介入和诊断性影像学报告阴性可能导致延迟诊断和再次吻合口吻合口漏。在三分之二的患者中，延迟时间超过了两天。

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