Komori Koji, Kimura Kenya, Kinoshita Takashi, Ito Seiji, Abe Tetsuya, Senda Yoshiki, Misawa Kazunari, Ito Yuichi, Uemura Norihisa, Natsume Seiji, Kawai Ryosuke, Kawakami Jiro, Asano Tomonari, Iwata Yoshinori, Kurahashi Shintaro, Tsutsuyama Masayuki, Shigeyoshi Itaru, Shimizu Yasuhiro
Department of Gastroenterological Surgery, Aichi Cancer Center Hospital, Nagoya, Aichi 464-8681, Japan.
Int Surg. 2014 Nov-Dec;99(6):719-22. doi: 10.9738/INTSURG-D-14-00122.1.
This study aimed to assess the pathogenic causes, clinical conditions, surgical procedures, in-hospital mortality, and operative death associated with emergency operations at a high-volume cancer center. Although many reports have described the contents, operative procedures, and prognosis of elective surgeries in high-volume cancer centers, emergency operations have not been studied in sufficient detail. We retrospectively enrolled 28 consecutive patients who underwent emergency surgery. Cases involving operative complications were excluded. The following surgical procedures were performed during emergency operations: closure in 3 cases (10.7%), diversion in 22 cases (78.6%), ileus treatment in 2 cases (7.1%), and hemostasis in 1 case (3.6%). Closure alone was performed only once for peritonitis. Diversion was performed in 17 cases (77.3%) of peritonitis, 4 cases (18.2%) of stenosis of the gastrointestinal tract, and 1 case (4.5%) of bleeding. There was a significant overall difference (P = 0.001). The frequency of emergency operations was very low at a high-volume cancer center. However, the recent shift in treatment approaches toward nonoperative techniques may enhance the status of emergency surgical procedures. The results presented in this study will help prepare for emergency situations and resolve them as quickly and efficiently as possible.
本研究旨在评估一家大型癌症中心急诊手术的致病原因、临床状况、手术操作、院内死亡率及手术死亡情况。尽管许多报告描述了大型癌症中心择期手术的内容、手术操作及预后，但急诊手术尚未得到足够详细的研究。我们回顾性纳入了28例连续接受急诊手术的患者。排除涉及手术并发症的病例。急诊手术期间进行了以下手术操作：3例（10.7%）行闭合术，22例（78.6%）行改道术，2例（7.1%）行肠梗阻治疗，1例（3.6%）行止血术。仅对腹膜炎行一次单纯闭合术。改道术在17例（77.3%）腹膜炎、4例（18.2%）胃肠道狭窄及1例（4.5%）出血患者中进行。存在显著的总体差异（P = 0.001）。在大型癌症中心，急诊手术的频率非常低。然而，近期治疗方法向非手术技术的转变可能会提升急诊手术的地位。本研究呈现的结果将有助于为紧急情况做好准备，并尽可能快速有效地解决这些情况。
