Department of Surgery, The University of Kansas, 4000 Cambridge, M/S 2005, Kansas City, KS, 66160, USA.
Int J Colorectal Dis. 2021 Feb;36(2):265-269. doi: 10.1007/s00384-020-03756-y. Epub 2020 Sep 22.
Rectal foreign bodies can pose a unique problem to the acute care surgeon or emergency room physician. Little data exists on the patient with such a diagnosis, outside of case reports, and institutional cohorts. This study describes demographics and outcomes for this patient population.
An analysis of the American College of Surgeons National Surgical Quality Improvement Program (ACS NSQIP) database (2015 to 2018) was performed, capturing patients with a postoperative diagnosis of foreign body of the anus or rectum. Patients were stratified into two groups: those who underwent removal under anesthesia (EUA) and those who required surgical removal. Baseline demographics and outcomes were compared and described.
A total of 109 patients were included in the study. The average age was 49.29 ± 14.63 years. The majority of the population was male (92.66%) and white (78.90%). Demographics and preoperative variables were clinically similar between patients receiving an EUA or an operation. Length of stay was longer in patients receiving an operation (4.84 ± 3.27 versus 1.39 ± 3.20 days in those receiving an EUA, p < 0.0001). About 97.24% of the population discharged to their home residence.
This study describes a population of patients admitted for retained foreign body of the rectum, in a population larger than that can be described in a typical institutional review. EUA can be a safe approach to foreign body removal, with laparotomy carrying the typical risks of surgery. This population requires further study to identify the mechanisms and risk factors for alimentary tract injury to reduce operative interventions and improve outcomes.
直肠异物可能会给急症外科医生或急诊室医生带来独特的问题。除了病例报告和机构队列外,关于此类诊断患者的数据很少。本研究描述了该患者人群的人口统计学和结果。
对美国外科医师学会国家手术质量改进计划(ACS NSQIP)数据库(2015 年至 2018 年)进行了分析,该数据库捕获了术后诊断为肛门或直肠异物的患者。患者分为两组:接受全身麻醉下取出(EUA)的患者和需要手术取出的患者。比较并描述了基线人口统计学和结果。
共有 109 例患者纳入本研究。平均年龄为 49.29 ± 14.63 岁。大多数患者为男性(92.66%)和白人(78.90%)。接受 EUA 或手术的患者之间的人口统计学和术前变量在临床上相似。接受手术的患者的住院时间更长(4.84 ± 3.27 天比接受 EUA 的患者的 1.39 ± 3.20 天,p < 0.0001)。约 97.24%的患者出院回家。
本研究描述了因直肠内残留异物而住院的患者人群,其规模大于典型机构审查中所能描述的规模。EUA 是一种安全的异物取出方法,而剖腹手术则具有手术的典型风险。该人群需要进一步研究,以确定食肠道损伤的机制和危险因素,以减少手术干预并改善结果。