...
  • 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Non-elective paraesophageal hernia repair: surgical approaches and short-term outcomes
【24h】

Non-elective paraesophageal hernia repair: surgical approaches and short-term outcomes

机译：非选择性审慎疝修复：手术方法和短期结果

获取原文
获取原文并翻译 | 示例
           
页面导航
  • 摘要
  • 著录项
  • 相似文献
  • 相关主题

摘要

Background The majority of laparoscopic paraesophageal hernia (PEH) repairs are performed electively. We aimed to investigate the frequency of non-elective laparoscopic (MIS) PEH repair and compare 30-day outcomes to elective MIS repairs and non-elective open repairs. We hypothesized that an increasing percentage of non-elective PEH repairs would be performed laparoscopically and that this population would have improved outcomes compared to non-elective open PEH counterparts. Methods The 2011-2016 NSQIP PUFs were used to identify patients who underwent PEH repair. Case status was classified as open vs. MIS and elective versus non-elective. Preoperative patient characteristics, operative details, discharge destination, and 30-day postoperative complication rates were compared. Logistic regression was used to examine the impact of case status on 30-day mortality. Results We identified 20,010 patients who underwent PEH. There were an increasing number of MIS PEH repairs in NSQIP between 2011 and 2016. Non-elective repairs were performed in 2,173 patients and 73.4% of these were completed laparoscopically. Elective MIS patients were younger, had a higher BMI, and were more likely to be functionally independent (p < 0.01) than their non-elective counterparts. Non-elective MIS patients had a higher wound class and ASA class compared to their elective counterparts. Compared to elective MIS cases, non-elective MIS PEH repair was associated with increased odds of mortality, even after controlling for patient characteristics (OR = 1.76,p = 0.02). There was no statistically significant difference in mortality for non-elective MIS vs. non-elective open PEH repair. There is an increase in non-elective PEH repairs recorded in NSQIP over time studied. Conclusions The population undergoing non-elective MIS PEH repairs is different from their elective MIS counterparts and experience a higher postoperative mortality rate. While the observed increased utilization of MIS techniques in non-elective PEH repairs likely provides benefits for the patient, there remain differences in outcomes for these patients compared to elective PEH repairs.
机译：背景大多数腹腔镜食管旁疝（PEH）修补术是选择性的。我们的目的是调查非选择性腹腔镜（MIS）PEH修复的频率，并将30天的结果与选择性MIS修复和非选择性开放性修复进行比较。我们假设越来越多的非选择性PEH修补术将通过腹腔镜进行，并且与非选择性开放性PEH患者相比，这一人群的预后会有所改善。方法采用2011-2016年NSQIP PUFs对接受PEH修复的患者进行识别。病例状态分为开放性与MIS，选择性与非选择性。比较术前患者特征、手术细节、出院目的地和术后30天并发症发生率。Logistic回归用于检验病例状态对30天死亡率的影响。结果我们确定了20010名接受PEH治疗的患者。2011年至2016年间，NSQIP的MIS PEH维修数量不断增加。2173例患者进行了非选择性修复，其中73.4%通过腹腔镜完成。与非选择性MIS患者相比，选择性MIS患者更年轻，BMI更高，功能独立性更高（p<0.01）。非选择性MIS患者的伤口等级和ASA等级高于选择性MIS患者。与选择性MIS病例相比，非选择性MIS PEH修复与死亡率增加相关，即使控制了患者特征（OR=1.76，p=0.02）。非选择性MIS与非选择性开放性PEH修复的死亡率无统计学显著差异。NSQIP中记录的非选择性PEH修复随着研究时间的推移而增加。结论接受非选择性MIS PEH修复的人群与选择性MIS患者不同，术后死亡率较高。虽然在非选择性PEH修复中观察到MIS技术的使用增加可能为患者带来益处，但与选择性PEH修复相比，这些患者的结果仍然存在差异。

著录项

相似文献

  • 外文文献
  • 中文文献
  • 专利
获取原文

客服邮箱：kefu@zhangqiaokeyan.com

京公网安备：11010802029741号 ICP备案号：京ICP备15016152号-6 六维联合信息科技 (北京) 有限公司©版权所有

  • 客服微信

  • 服务号