Tsumura Hiroaki, Ichikawa Toru, Hiyama Eiso, Murakami Yoshiaki
Department of Surgery, Hiroshima Municipal Funairi Hospital, Hiroshima University School of Medicine, Hiroshima, Japan.
Hepatogastroenterology. 2004 Sep-Oct;51(59):1536-9.
BACKGROUND/AIMS: To improve the perioperative course and quality of life of the patients with perforated peptic ulcer, we investigated the conversion risk factors in laparoscopic simple closure and omental patch repair for perforated peptic ulcer.
A total of 71 patients with a mean age of 46 years (rage, 17-81 years) was examined, and their clinical data was recorded and analyzed.
The postoperative durations of nasogastric tube insertion, ileus, analgesic requirement, resuming diet, and hospital stay were shorter in the patients with laparoscopic simple closure than in those with open simple closure and omental patch repair. Univariate regression analysis revealed that the age, American Society of Anesthesiologist classification, presence of concomitant disease, and length of free air or fluid collection shown in abdominal computerized tomography significantly correlated with the conversion of laparoscopic simple closure and omental patch repair to open simple closure and omental patch repair.
These conversion factors are useful to achieve appropriate surgical treatments for perforated peptic ulcer.
背景/目的:为改善穿孔性消化性溃疡患者的围手术期过程及生活质量,我们对穿孔性消化性溃疡腹腔镜单纯缝合及网膜修补术的中转危险因素进行了研究。
共检查了71例平均年龄46岁(范围17 - 81岁)的患者,并记录和分析了他们的临床资料。
腹腔镜单纯缝合患者术后鼻胃管留置时间、肠梗阻时间、镇痛需求、恢复饮食时间及住院时间均短于开腹单纯缝合及网膜修补患者。单因素回归分析显示,年龄、美国麻醉医师协会分级、合并疾病的存在以及腹部计算机断层扫描显示的游离气体或积液长度与腹腔镜单纯缝合及网膜修补术中转开腹单纯缝合及网膜修补术显著相关。
这些中转因素有助于对穿孔性消化性溃疡采取合适的手术治疗。