急性阑尾炎患者手术延迟一晚是否安全？
Is a One Night Delay of Surgery Safe in Patients With Acute Appendicitis?
作者信息
Lee Jae Min, Kwak Beom Seok, Park Young Jin
机构信息
Department of Surgery, Dongguk University Ilsan Hospital, Ilsan, Korea.
出版信息
Ann Coloproctol. 2018 Feb;34(1):11-15. doi: 10.3393/ac.2018.34.1.11. Epub 2018 Feb 28.
PURPOSE
With varied reports on the impact of time to appendectomy on clinical outcomes, the purpose of this study was to determine the effect of preoperative in-hospital delay on the outcome for patients with acute appendicitis.
METHODS
A retrospective review of 1,076 patients who had undergone an appendectomy between January 2010 and December 2013 was conducted.
RESULTS
The outcomes of surgery and the pathologic findings were analyzed according to elapsed time. The overall elapsed time from onset of symptoms to surgery was positively associated with advanced pathology, increased number of complications, and prolonged hospital stay. In-hospital elapsed time was not associated with any advanced pathology (P = 0.52), increased number of postoperative complications (P = 0.14), or prolonged hospital stay (P = 0.24). However, the complication rate was increased when the in-hospital elapsed time exceeded 18 hours.
CONCLUSION
Advanced pathology and postoperative complication rate were associated with overall elapsed time from symptom onset to surgery rather than in-hospital elapse time. Therefore, a short-term delay of an appendectomy should be acceptable.
目的
鉴于关于阑尾切除术时机对临床结局影响的报道各异，本研究旨在确定术前住院延迟对急性阑尾炎患者结局的影响。
方法
对2010年1月至2013年12月期间接受阑尾切除术的1076例患者进行回顾性研究。
结果
根据病程时间分析手术结局和病理结果。从症状出现到手术的总病程时间与病理进展、并发症数量增加及住院时间延长呈正相关。住院病程时间与任何病理进展（P = 0.52）、术后并发症数量增加（P = 0.14）或住院时间延长（P = 0.24）均无关联。然而，当住院病程时间超过18小时时，并发症发生率会增加。
结论
病理进展和术后并发症发生率与从症状出现到手术的总病程时间相关，而非与住院病程时间相关。因此，阑尾切除术的短期延迟应是可接受的。
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