• 主题
高级搜索  >
历史搜索 清空历史
首页> 外文期刊>Surgical Endoscopy >Laparoscopic versus open repair of parastomal hernias: an ACS-NSQIP analysis of short-term outcomes.
【24h】

Laparoscopic versus open repair of parastomal hernias: an ACS-NSQIP analysis of short-term outcomes.

机译：腹腔镜与开放式修复口旁疝：近期结果的ACS-NSQIP分析。

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

Parastomal hernia (PSH) is a frequent complication following the creation of a stoma. While a significant number of cases require operative management, data comparing short-term outcomes of laparoscopic versus open repair of parastomal hernias are limited.The ACS-NSQIP was retrospectively reviewed from 2005 to 2011 for all PSH cases that underwent open or laparoscopic repair. Patients characteristics, operative details, and outcomes were listed for both procedure types. Selected end points were compared on multivariate regression analysis.Among the 2,167 identified parastomal hernia cases, only 222 (10.24 %) were treated laparoscopically. The open and laparoscopic groups were similar with respect to mean patient age (63 vs. 63 years; p = 1) and gender distribution as the majority of patients were females (56.8 %). However, open repair was more likely to be performed in patients with a higher ASA class (III and IV) (p < 0.001). Also, the open approach was more likely to be used emergently (8.64 vs. 3.60 %; p = 0.01) and for recurrent hernias (6.99 vs. 3.15 %; p < 0.05). After adjusting for all potential confounders including age, gender, ASA, emergency designation of the operation, hernia type, and wound class, laparoscopy was associated with shorter operative time (137.5 vs. 153.4 min; p < 0.05), shorter length of hospital stay by 3.32 days (p < 0.001), lower risk of overall morbidity (OR = 0.42; p < 0.001), and a lower risk of surgical site infections (OR = 0.35; p < 0.01) compared to open repair. Mortality rates were similar in the laparoscopic and open groups (0.45 vs. 1.59 %, respectively; p = 0.29).Laparoscopic parastomal hernia repair is safe and appears to be associated with better short-term outcomes compared to open repair in selected cases. Large prospective randomized trials are needed to confirm those results and to assess long-term recurrence rates.
机译：气孔旁造口疝（PSH）是一种常见的并发症。虽然大量病例需要手术治疗，但比较腹腔镜与开放修补旁口旁疝的近期结果的数据有限.2005年至2011年对所有行开放或腹腔镜修补的PSH病例进行了ACS-NSQIP回顾性审查。两种手术类型均列出了患者特征，手术细节和结局。在多因素回归分析中比较了选定的终点。在2167例经鉴定的口旁疝病例中，只有222例（10.24％）经腹腔镜治疗。开放式和腹腔镜检查组在平均患者年龄（63岁对63岁; p = 1）和性别分布方面相似，因为大多数患者为女性（56.8％）。但是，ASA等级较高（III和IV）的患者更有可能进行开放式修复（p <0.001）。而且，更可能紧急使用开放式入路（8.64 vs. 3.60％; p = 0.01）和复发性疝（6.99 vs. 3.15％; p <0.05）。在对所有可能的混杂因素（包括年龄，性别，ASA，手术的紧急指征，疝气类型和伤口类型）进行调整后，腹腔镜检查与较短的手术时间（137.5 vs. 153.4 min; p <0.05），住院时间较短有关与开放式修复相比，在3.32天之前（p <0.001），总体发病率较低（OR = 0.42; p <0.001），并且手术部位感染的风险较低（OR = 0.35; p <0.01）。腹腔镜和开腹组的死亡率相似（分别为0.45％vs. 1.59％; p = 0.29）。腹腔镜下造口疝修补术是安全的，并且在某些情况下与开放式修复相比似乎具有更好的短期预后。需要进行大规模的前瞻性随机试验，以确认这些结果并评估长期复发率。

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