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首页> 外文期刊>Surgical Endoscopy >Peritoneal perforation during transanal endoscopic microsurgery is not associated with significant short-term complications
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Peritoneal perforation during transanal endoscopic microsurgery is not associated with significant short-term complications

机译：躯体内窥镜显微外科治疗过程中的腹膜穿孔与显着短期并发症无关

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BackgroundIn patients treated by transanal endoscopic microsurgery (TEM), breach of the peritoneal cavity is a feared intraoperative challenge. Our aim is to analyze predictors and short-term outcomes of patients with peritoneal perforation (TEM-P) when compared to similar patients with no peritoneal compromise (TEM-N).MethodsAt St. Paul's Hospital, demographic, surgical, pathologic, and follow-up data for all patients treated by TEM is maintained in a prospectively populated database. A retrospective review was performed and two groups were established for comparison: TEM-P and TEM-N. Statistical analysis was performed using student's t or chi-squared test, where appropriate.ResultsOf 619 patients treated by TEM between 2007 and 2016, 39 (6%) patients were in the TEM-P group and 580 (94%) in the TEM-N group. There were no differences between the groups in patient age, gender, histology, or tumor size. Patients who had peritoneal perforations had more proximal lesions (11 vs. 7cm, p<0.0001), anterior lesions (56 vs. 43%, p<0.05), and longer operations (80 vs. 51min, p<0.005). While most defects were closed endoluminally, 2 patients with perforation were converted to transabdominal surgery. There was a difference in overall hospital stay with TEM-P patients staying on average 2days in hospital with fewer patients managed as day surgery (31 vs. 73%, p<0.0001). There were no mortalities or significant 30-day complications in the TEM-P group and only one patient required readmission.ConclusionsThe St. Paul's Hospital TEM experience suggests patients with peritoneal breach during TEM can be safely managed with outcomes similar to patients without peritoneal entry. Proximal, anterior lesions are at highest risk of peritoneal perforation.
机译：背景患者由常规内窥镜显微外科（TEM）治疗，突破腹膜腔是令人担忧的术中攻击。我们的宗旨是分析腹膜穿孔患者的预测因子和短期结果（TEM-P），与没有腹膜妥协（TEM-N）.Methodsat圣保罗的医院，人口统计学，手术，病理和跟随由TEM治疗的所有患者的-UP数据维持在普遍填充的数据库中。进行了回顾性审查，建立了两组进行比较：TEM-P和TEM-n。使用学生的T或Chi平方测试进行统计分析，其中适当的是，在2007年至2016年期间，39（6％）患者在TEM-P组和580（94％）之间进行了619名患者的619名患者。 n组。患者年龄，性别，组织学或肿瘤大小之间的群体之间没有差异。患有腹膜穿孔的患者具有更多的近端病变（11比7cm，P <0.0001），前病变（56 vs.30％，P <0.05）和更长的操作（80 vs.51min，P <0.005）。虽然大多数缺陷闭合尾肿，但2例穿孔患者被转化为转腹手术。整体住院住院差异差异，TEM-P患者平均2天在医院中持平，较少的患者担任当天手术（31 vs.73％，P <0.0001）。 Tem-P组没有死亡或显着的30天并发症，只有一名患者只需要一名患者Readmission.Conclusionsthe St. Paul的医院Tem经验表明TEM的患者可以使用与没有腹膜进入的患者类似的患者安全管理。近端，前病变处于腹膜穿孔的最高风险。

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