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糖尿病对重大机器人肝切除术的影响。

The effect of diabetes on major robotic hepatectomy.

机构信息

AdventHealth Tampa, Digestive Health Institute, Tampa, FL, USA.

AdventHealth Tampa, 3000 Medical Park Drive Suite 500, Tampa, FL, 33613, USA.

出版信息

J Robot Surg. 2022 Feb;16(1):137-142. doi: 10.1007/s11701-021-01223-6. Epub 2021 Mar 8.

Abstract

Studies regarding the influence of diabetes on perioperative outcomes after major hepatectomy are conflicting. The objective of this study is to analyze the effects of diabetes on patients undergoing robotic major hepatectomy. With Institutional Review Board (IRB) approval, 94 patients undergoing major hepatectomy were prospectively followed. Demographic data and postoperative outcomes were analyzed and compared between diabetic and non-diabetic patients. Data were presented as median (mean ± SD). Patients were of age 62 (61 ± 13.0) years, BMI of 29 (29 ± 5.9) kg/m, and ASA class of 3 (3 ± 0.55). The mass size was 5 (5 ± 3.0) cm. Operative duration was 252 (277 ± 106.6) min with estimated blood loss (EBL) was 175 (249 ± 275.9) mL. One operation was converted to 'open' due to bleeding, accounting for one intraoperative complication. Postoperatively, nine patients required ICU admission, with a duration of 1 (4 ± 5.9) day. Seven patients had postoperative complications. Length of stay (LOS) was 4 (4 ± 2.6) days. Fourteen patients were readmitted within 30 days. There were no deaths in-hospital or within 30 days. Of the 94 patients, 22 were diabetic and 72 were nondiabetic. Diabetic patients were older (70 (69 ± 11.3) years versus 58 (58 ± 12.4) years (p = 0.004)). Intraoperatively, operative duration, EBL, and complications were not significantly different. Postoperatively, LOS, ICU admission, ICU duration, complications, in-hospital mortality, readmission in 30 days, and death after 30 days showed no significant difference between diabetics and nondiabetics. In our experience, diabetes has no significant effect on perioperative outcomes after a robotic major hepatectomy.

摘要

关于糖尿病对肝切除术围手术期结果影响的研究结果存在争议。本研究旨在分析糖尿病对接受机器人肝切除术患者的影响。本研究通过机构审查委员会(IRB)批准,前瞻性随访了 94 例接受肝切除术的患者。分析并比较了糖尿病患者和非糖尿病患者的人口统计学数据和术后结果。数据以中位数(平均值±标准差)表示。患者年龄为 62 岁(61±13.0)岁,BMI 为 29kg/m²(29±5.9kg/m²),ASA 分级为 3 级(3±0.55)。肿瘤大小为 5cm(5±3.0cm)。手术时间为 252 分钟(277±106.6 分钟),估计出血量(EBL)为 175 毫升(249±275.9 毫升)。有 1 例患者因出血转为开腹手术,术中发生 1 例并发症。术后,9 例患者需要入住 ICU,持续 1 天(4±5.9 天)。7 例患者发生术后并发症。住院时间(LOS)为 4 天(4±2.6 天)。14 例患者在 30 天内再次入院。院内或 30 天内无死亡。94 例患者中,22 例为糖尿病患者,72 例为非糖尿病患者。糖尿病患者年龄较大(70 岁(69±11.3 岁)与 58 岁(58±12.4 岁)(p=0.004))。术中手术时间、EBL 和并发症无显著差异。术后 LOS、ICU 入住、ICU 持续时间、并发症、院内死亡率、30 天内再入院率和 30 天后死亡率在糖尿病患者和非糖尿病患者之间无显著差异。根据我们的经验,糖尿病对机器人肝切除术围手术期结果没有显著影响。

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