急诊阑尾切除术期间阑尾残端的处理：英国当前外科实践中的选择及影响因素
Securing the Appendiceal Stump During Emergency Appendicectomy: Options and Influencing Factors in Current UK Surgical Practice.
作者信息
Wilson Michael S J, Knight Stephen R, Vaughan-Shaw Peter
机构信息
Department of General Surgery, NHS Tayside, Ninewells Hospital, Dundee.
Department of General Surgery, Monklands Hospital, Airdrie.
出版信息
Surg Laparosc Endosc Percutan Tech. 2018 Aug;28(4):209-213. doi: 10.1097/SLE.0000000000000558.
INTRODUCTION
The aim of our study was to identify the most commonly employed methods and influencing factors for securing the appendiceal stump in current NHS practice.
METHODS
An electronic survey of the Scottish Surgical Research Group network, invitation extended to the UK National Research Collaborative.
RESULTS
A total of 111 responses were received from 32 surgical centers; 28 (25.2%) consultants, 66 (59.5%) specialty trainees and 12 (10.8%) core trainees. Endoscopic ligatures were the preferred method in 96 (86.5%) with no difference in those with the greatest operative experience (P=0.79), 12 (10.8%) preferred polymeric clips. Ease of application (70.3%) and severity of stump inflammation (65.8%) had the greatest influence on the method chosen. Cost was a factor in 36.0%.
CONCLUSIONS
The preferred method for securing the appendiceal stump in UK practice is endoscopic ligatures regardless of operative experience. Factors with the greatest influence on the method employed include the ease of application and severity of stump inflammation. Our findings are likely to be representative of current NHS practice in Scotland.
引言
我们研究的目的是确定在当前英国国民医疗服务体系（NHS）的实践中，用于固定阑尾残端最常用的方法和影响因素。
方法
对苏格兰外科研究小组网络进行电子调查，并向英国国家研究协作组织发出邀请。
结果
共收到来自32个外科中心的111份回复；其中28名（25.2%）为顾问医生，66名（59.5%）为专科培训医生，12名（10.8%）为核心培训医生。96名（86.5%）医生首选内镜结扎法，手术经验最丰富的医生在这方面无差异（P = 0.79），12名（10.8%）医生首选聚合物夹。应用的难易程度（70.3%）和残端炎症的严重程度（65.8%）对所选方法影响最大。成本是36.0%的医生考虑的一个因素。
结论
在英国的实践中，无论手术经验如何，固定阑尾残端的首选方法是内镜结扎法。对所采用方法影响最大的因素包括应用的难易程度和残端炎症的严重程度。我们的研究结果可能代表了苏格兰当前NHS的实践情况。
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