Department of Orthopedic Surgery, NYU Langone Orthopedic Hospital, NYU Langone Health, New York, NY.
J Arthroplasty. 2019 Nov;34(11):2780-2784. doi: 10.1016/j.arth.2019.06.026. Epub 2019 Jun 15.
Gastrointestinal (GI) complications following total joint arthroplasty (TJA) are uncommon but can be associated with substantial morbidity and mortality. The current literature on GI complications that warrant invasive procedures after TJA is lacking. This study reviews the incidence and outcomes of GI complications after TJA that went on to require invasive procedures.
All TJA patients at our institution between January 2012 and May 2018 who had GI complications requiring an invasive procedure within 30 days of TJA were identified and retrospectively chart reviewed. Descriptive statistics were used to evaluate these patients.
Of 19,090 TJAs in a 6-year period, 34 patients (0.18%) required invasive procedures for GI complications within 30 days of the index surgery. Twenty-two (64%) of the required procedures were endoscopy for suspected GI bleeding. Within this cohort, aspirin was the most common thromboprophylaxis used (63.6% of patients) and smoking was more prevalent (9.1% current smokers) (P = .28). Of the remaining 12 GI procedures required, 75% were exploratory laparotomies, 44.4% of which were performed for obstruction. Three (33.3%) of the exploratory laparotomy patients died during the study period.
GI complications necessitating surgical intervention after TJA are rare. Suspected GI bleeding is the most common indication for intervention and is typically managed endoscopically. Other complications, such as GI obstruction, often require more extensive intervention and open procedures. Though rare, GI complications following TJA can lead to detrimental outcomes, significant patient morbidity, and occasionally mortality; therefore, a heightened awareness of these complications is warranted.
全关节置换术后（TJA）的胃肠道（GI）并发症并不常见，但可导致严重的发病率和死亡率。目前关于 TJA 后需要侵入性手术的 GI 并发症的文献缺乏。本研究回顾了 TJA 后需要侵入性手术的 GI 并发症的发生率和结局。
在我院 2012 年 1 月至 2018 年 5 月期间，所有 TJA 患者中，有 34 例（0.18%）在 TJA 后 30 天内出现需要侵入性手术的 GI 并发症，并进行了回顾性图表审查。采用描述性统计方法评估这些患者。
在 6 年期间的 19090 例 TJA 中，有 34 例（0.18%）患者在索引手术后 30 天内需要侵入性手术治疗 GI 并发症。在这一队列中，22 例（64%）需要的手术是为疑似 GI 出血进行的内镜检查。在这一组中，最常用的抗血栓药物是阿司匹林（63.6%的患者），吸烟更为常见（9.1%的现吸烟者）（P=0.28）。在其余需要的 12 项 GI 手术中，75%是剖腹探查术，其中 44.4%是为梗阻而进行的。在研究期间，3 名（33.3%）剖腹探查术患者死亡。
TJA 后需要手术干预的 GI 并发症很少见。疑似 GI 出血是干预的最常见指征，通常通过内镜治疗。其他并发症，如 GI 梗阻，通常需要更广泛的干预和开放手术。尽管罕见，但 TJA 后 GI 并发症可导致不良结局、严重的患者发病率，有时甚至死亡；因此，有必要提高对这些并发症的认识。
