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与紧急直肠异物处理相关的特征及结果:一项回顾性队列分析。

Characteristics and Outcomes Associated With Emergent Rectal Foreign Body Management: A Retrospective Cohort Analysis.

作者信息

Frendt Eric, Masroor Momin, Saied Arman, Neeki Arianna, Youssoffi Santana, Malkoc Aldin, Dong Fanglong, Tran Louis, Borger Rodney, Wong David T, Neeki Michael

机构信息

Emergency Department, Arrowhead Regional Medical Center, Colton, USA.

Emergency Department, California University of Science and Medicine, Colton, USA.

出版信息

Cureus. 2023 Nov 25;15(11):e49413. doi: 10.7759/cureus.49413. eCollection 2023 Nov.

Abstract

Background Bedside management and outcomes of rectal foreign bodies remain challenging due to the presentation and complexity of the inserted objects. Injuries, such as perforation of the colon and rectum, are among the most commonly reported complications. However, prior studies are unclear regarding the setting in which the complication rates may be minimized. This study aimed to assess whether there was a statistically significant difference among the various extraction methods with regard to complications in the emergency department and operating room. Materials and methods This was a retrospective study of all cases of rectal foreign bodies that were removed in the emergency department at a large county hospital between 1/1/2010 and 12/31/2020. Patients included in this study were adults who were evaluated and treated in the emergency department. Results A total of 78 patients were included in the final analysis. More than half (51.3%, n=40) of the patients were successfully treated in the emergency department. Compared with the emergency department, patients in the operating room were more likely to undergo exploratory laparotomy and colectomy (0% vs. 31.6%, p<0.0001), undergo general anesthesia (84.2% vs. 0%, p<0.0001), have higher complication rates (21% vs. 0%, p=0.0021), and have a longer hospital length of stay (median=1 vs. 0, p<0.0001). Conclusion This study revealed a >50% success rate of rectal foreign body removal in the emergency department without any reported complications. To improve the success rate of bedside retrieval and decrease complications, physicians need to be vigilant, communicative, and compassionate about their evaluations and clinical methodology.

摘要

背景 由于插入物体的表现形式和复杂性,直肠异物的床边管理和治疗结果仍然具有挑战性。结肠和直肠穿孔等损伤是最常报告的并发症之一。然而,先前的研究尚不清楚在何种情况下并发症发生率可以降至最低。本研究旨在评估在急诊科和手术室中,各种取出方法在并发症方面是否存在统计学上的显著差异。

材料和方法 这是一项对2010年1月1日至2020年12月31日期间在一家大型县医院急诊科取出的所有直肠异物病例的回顾性研究。本研究纳入的患者为在急诊科接受评估和治疗的成年人。

结果 共有78例患者纳入最终分析。超过一半(51.3%,n = 40)的患者在急诊科得到成功治疗。与急诊科相比,手术室的患者更有可能接受剖腹探查术和结肠切除术(0%对31.6%,p < 0.0001),接受全身麻醉(84.2%对0%,p < 0.0001),并发症发生率更高(21%对0%,p = 0.0021),住院时间更长(中位数 = 1天对0天,p < 0.0001)。

结论 本研究显示,急诊科直肠异物取出成功率超过50%,且无任何报告的并发症。为提高床边取出成功率并减少并发症,医生在评估和临床方法上需要保持警惕、善于沟通并富有同情心。

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