Böttger Th C, Hermeneit S, Müller M, Terzic A, Rodehorst A, Elad L, Schamberger M
Klinik für Viszeral-, Thorax- und Gefässchirurgie, Zentrum für minimalinvasive Chirurgie, Klinikum Bremerhaven Reinkenheide, Bremerhaven, Germany.
Surg Endosc. 2009 Sep;23(9):2016-25. doi: 10.1007/s00464-008-9916-x. Epub 2009 May 22.
In contrast to patient-related risk factors, which are difficult to influence, factors relating to surgery and anesthesia that can be influenced have hardly been investigated. This study aimed to identify such risk factors.
Pre- and intraoperative surgical and anesthesiologic factors of 388 colonic and 112 rectal procedures performed by a single surgeon within 50 months were recorded and analyzed for correlations with postoperative complications requiring treatment.
Higher American Society of Anesthesiology (ASA) emergency interventions and intraoperative factors (bleeding, long operating time) had an elevated risk for general complications. Furthermore, patients benefited from the clinical experience of the anesthesiologist, especially in terms of emergency procedures, hemorrhagic complications, and a longer operating time.
Standardization of the surgical technique, "bloodless" surgery, standardization of intraoperative monitoring, and the use of board-certified anesthesiologists for high-risk cases, emergency procedures, and patients with high ASA stages are able to reduce postoperative morbidity.
与难以施加影响的患者相关风险因素不同，那些与手术和麻醉相关且可施加影响的因素几乎未得到研究。本研究旨在识别此类风险因素。
记录并分析了一位外科医生在50个月内实施的388例结肠手术和112例直肠手术的术前及术中手术和麻醉因素，以探讨其与需要治疗的术后并发症的相关性。
较高的美国麻醉医师协会（ASA）分级、急诊手术以及术中因素（出血、手术时间长）会增加发生一般并发症的风险。此外，患者受益于麻醉医生的临床经验，尤其是在急诊手术、出血性并发症及手术时间较长方面。
手术技术标准化、“无血”手术、术中监测标准化以及为高危病例、急诊手术及ASA分级较高的患者配备获得委员会认证的麻醉医生，能够降低术后发病率。
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