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首页> 外文期刊>Surgical Endoscopy >Morbidity after transanal endoscopic microsurgery: risk factors for postoperative complications and the design of a 1-day surgery program
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Morbidity after transanal endoscopic microsurgery: risk factors for postoperative complications and the design of a 1-day surgery program

机译：经躯内镜显微外科术后发病率：术后并发症的危险因素和1天外科计划的设计

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Background Transanal endoscopic microsurgery (TEM) is a minimally invasive procedure with low morbidity. The definition of risk factors for postoperative complications would help to identify the patients likely to require more care and surveillance in an ambulatory or 1-day surgery (A-OdS) program. The main endpoints are overall 30-day morbidity and relevant morbidity. The secondary objectives are to detect risk factors for complications, rehospitalization, and the time of occurrence of the postoperative complications, and to describe the adverse effects following hospitalization that the A-OdS program would avoid. Methods This is an observational study of consecutive patients undergoing TEM between June 2004 and December 2016. Overall and relevant morbidity based on the Clavien-Dindo (C1-D) classification were recorded, as were demographic, preoperative, surgical, and pathology variables. Univariate and multivariate analyses of the risk factors were carried out. Results Six hundred and ninety patients underwent surgery, of whom 639 were included in the study. Overall morbidity rate was 151/639 patients (23.6%); the clinically relevant morbidity rate was 36/639 (C1-D > II) (5.6%) and mortality 2/639 (0.3%). The most frequent complication was rectal bleeding, recorded in 16.9% (108/639 patients) and grade I in 86/108 patients (78.9%). The period with the greatest risk of complications was the first 2 days. The rehospitalization rate after 48 h was 7%. The risk factors for complications were as follows: tumor size > 6 cm (OR 3.2, 95% CI 1.3-7.8), anti-platelet medication (OR 2.3, 95% CI 1.1-5.1), and surgeon's experience< 150 procedures (OR 2.0, 95% CI 1-4.1). Conclusions TEM is a safe procedure. The low rates of morbidity, re-hospitalization, and postoperative complications in the first 2 days after surgery make the procedure suitable for A-OdS.
机译：背景技术常规内窥镜显微外科（TEM）是一种低发病率的侵入性手术。术后并发症的危险因素的定义将有助于确定可能需要在手术或1天手术（A-ODS）方案中进行更多护理和监测的患者。主要终点是整体30天的发病率和相关的发病率。次要目标是检测并发症，再生生长和术后并发症的发生时间的危险因素，并描述住院后A-ODS计划避免的不利影响。方法这是2004年6月至2016年12月间接受过度的连续患者的观察研究。记录了基于Clavien-DINDO（C1-D）分类的总体和相关的发病率，以及人口统计，术前，手术和病理变量。进行了风险因素的单变量和多变量分析。结果六百九十名患者接受过手术，其中639名纳入该研究。总体发病率为151/639名（23.6％）;临床相关的发病率为36/639（C1-D> II）（5.6％）和死亡率2/639（0.3％）。最常见的并发症是直肠出血，记录在16.9％（108/639名患者）和86/108名患者（78.9％）中。具有最大并发症风险的时期是前2天。 48小时后的再生活率为7％。并发症的危险因素如下：肿瘤大小> 6厘米（或3.2,95％CI 1.3-7.8），抗血小板药物（或2.3,95％CI 1.1-5.1），以及外科医生的经验<150程序（或2.0,95％CI 1-4.1）。结论TEM是一个安全的程序。手术后前2天的发病率，重新住院和术后并发症的低率使得适合A-ODS的程序。

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