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首页> 外文期刊>Surgical Endoscopy >Laparoscopic appendectomy is safe and efficacious for the elderly: an analysis using the National Surgical Quality Improvement Project database.
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Laparoscopic appendectomy is safe and efficacious for the elderly: an analysis using the National Surgical Quality Improvement Project database.

机译：腹腔镜阑尾切除术对老年人是安全有效的：使用“国家手术质量改善计划”数据库进行的分析。

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BACKGROUND: Despite increasing use of laparoscopic appendectomy, data demonstrating outcomes of this technique exclusively among the elderly population are scarce. This study aimed to compare 30-day postoperative morbidity and length of hospital stay among elderly patients after appendectomy. METHODS: Appendicitis patients older than 65 years were extracted from the National Surgical Quality Improvement Project (NSQIP) database. Demographics and rates of complications for patients undergoing open and laparoscopic appendectomies were compared. Uni- and multivariate analyses adjusted for differences between groups compared the end points of major and minor complications as well as the days of hospital stay after initial surgery. RESULTS: A total of 3,335 patients underwent appendectomy, with 2,235 patients (67%) receiving a laparoscopic procedure. The open appendectomy patients were significantly older and more likely to have various preoperative comorbidities (p<0.05). No difference in median operative time between the two techniques was found. Both required 51 min (p=0.11). The open cases had higher rates of both major and minor postoperative complications than the laparoscopic cases (p<0.0001), both overall and before discharge. Multivariate analysis showed no association between operative approach and major complications, and a reduced risk of minor complications with laparoscopy. Length of surgical stay was longer for the open group than for the laparoscopically treated group (median, 4 days vs 2 days; p<0.05). After adjustment, laparoscopy still was significantly associated with a shorter hospital stay than open appendectomy (p<0.0001). CONCLUSIONS: Laparoscopic appendectomy is a safe procedure for elderly patients. During the 30-day postoperative period, no correlation with major complications was found, and the findings showed a beneficial association with regard to minor complications. After adjustment for perioperative factors, laparoscopy is associated with a shorter hospital stay than open appendectomy.
机译：背景：尽管越来越多地使用腹腔镜阑尾切除术，但仅在老年人群中证明该技术结局的数据却很少。该研究旨在比较阑尾切除术后老年患者术后30天的发病率和住院时间。方法：从国家手术质量改善计划（NSQIP）数据库中提取65岁以上的阑尾炎患者。比较了接受开腹和腹腔镜阑尾切除术的患者的人口统计学和并发症发生率。根据两组之间的差异进行单因素和多因素分析，比较主要和次要并发症的终点以及首次手术后的住院天数。结果：共有3335例患者接受了阑尾切除术，其中2235例患者（67％）接受了腹腔镜手术。开放性阑尾切除术患者年龄较大，更有可能发生各种术前合并症（p <0.05）。两种技术之间的中位手术时间无差异。两者都需要51分钟（p = 0.11）。在整体和出院前，开放病例的主要和次要术后并发症发生率均高于腹腔镜病例（p <0.0001）。多变量分析显示腹腔镜手术与主要并发症之间无关联，并降低了轻微并发症的风险。开放组的手术住院时间长于腹腔镜治疗组（中位4天vs 2天; p <0.05）。调整后，腹腔镜检查仍比开放阑尾切除术的住院时间短（p <0.0001）。结论：腹腔镜阑尾切除术对老年患者是安全的。术后30天期间，未发现与主要并发症相关，并且发现与较小并发症相关。调整围手术期因素后，腹腔镜手术比开放式阑尾切除术住院时间短。

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