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急诊结肠切除术的概况及意义

Profile and significance of emergency colonic resections.

作者信息

Paton B Lauren, Mostafa Gamal, Lincourt Amy E, Kercher Kent W, Heniford B Todd

机构信息

Department of Surgery, Carolinas Medical Center, Charlotte, North Carolina 28203, USA.

出版信息

Am Surg. 2008 Apr;74(4):305-9.

Abstract

The objectives of this study are to define the distinguishing features between elective and emergency colonic surgery. The records of adult patients who underwent elective and emergent colonic resection over a 4-year period were retrospectively reviewed. Univariate analysis was performed to compare outcomes for elective and emergency procedures and multiple logistic regression analysis was performed to identify the significant predictors of outcome. Three hundred and thirty-eight elective and 147 emergency colonic resections were performed. Diverticular disease was most common in the emergency group (43.5% vs 14.2%, P = 0.001) whereas malignancy predominated in the elective group (56.2% vs 5.4%, P = 0.001). The emergency group accounted for 54.7 per cent and 79.3 per cent of the total morbidity and mortality. Emergency colonic surgery has distinctive features and significance. Emergency surgery for colonic obstruction and total/subtotal resection are associated with higher morbidity and mortality. Diverticular disease compares favorably to other pathologies in postoperative outcome.

摘要

本研究的目的是明确择期和急诊结肠手术之间的区别特征。回顾性分析了4年间接受择期和急诊结肠切除术的成年患者的记录。进行单因素分析以比较择期和急诊手术的结果,并进行多因素逻辑回归分析以确定结果的显著预测因素。共进行了338例择期和147例急诊结肠切除术。憩室病在急诊组最为常见(43.5%对14.2%,P = 0.001),而恶性肿瘤在择期组占主导(56.2%对5.4%,P = 0.001)。急诊组占总发病率和死亡率的54.7%和79.3%。急诊结肠手术有其独特的特征和意义。结肠梗阻的急诊手术以及全结肠/次全结肠切除术与更高的发病率和死亡率相关。憩室病在术后结果方面优于其他病理情况。

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