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既往手术类型并不预测小肠梗阻的手术干预。

Type of Prior Operation Does Not Predict Surgical Intervention for Small Bowel Obstruction.

机构信息

Department of Surgery, Eastern Virginia Medical School, Norfolk, VA, USA.

出版信息

Am Surg. 2024 Jul;90(7):1896-1898. doi: 10.1177/00031348241241709. Epub 2024 Mar 26.

Abstract

: Patients with prior abdominal surgeries are at higher risk for intra-abdominal adhesive tissue formation and subsequently higher risk for small bowel obstruction (SBO).: In this study, we investigated whether surgical intervention for SBO was more likely following specific types of abdominal surgeries.: With retrospective chart review, we pooled data from 799 patients, ages 18 to 89, admitted with SBO between 2012 and 2019. Patients were evaluated based on whether they underwent surgery or were managed conservatively. They were further compared with regard to past surgical history by way of type of abdominal surgery (or surgeries) undergone prior to admission.: Of the 799 patients admitted for SBO, 206 underwent surgical intervention while 593 were managed nonoperatively. There was no significant difference in number of prior surgeries (2.07 ± 1.56 vs 2.36 ± 2.11,  = .07) or in number of comorbidities (2.39 ± 1.97 vs 2.65 ± 1.93,  = .09) for surgical vs non-surgical intervention. Additionally, of the operations evaluated, no specific type of abdominal surgery predicted need for surgical intervention in the setting of SBO. However, for both surgical and non-surgical intervention following SBO, pelvic surgery was the most common type of prior abdominal surgery (45% vs 43%). There are significantly more female pelvic surgeries in both the operative (91.4% vs 8.6%,  < .0001) and nonoperative groups (89.9% vs 10.2%,  < .0001).: Ultimately, no specific type of prior operation predicted the need for surgical intervention in the setting of SBO.

摘要

: 既往腹部手术的患者发生腹腔内粘连组织形成的风险较高,随后发生小肠梗阻 (SBO) 的风险也较高。: 在这项研究中,我们研究了 SBO 的手术干预是否更可能发生在特定类型的腹部手术后。: 通过回顾性病历审查,我们汇集了 2012 年至 2019 年间因 SBO 入院的 799 名年龄在 18 至 89 岁的患者的数据。根据是否接受手术或保守治疗,对患者进行评估。然后,我们根据患者入院前接受的腹部手术类型(或手术)对他们的既往手术史进行了进一步比较。: 在因 SBO 入院的 799 名患者中,有 206 名接受了手术干预,593 名接受了非手术治疗。手术组与非手术组的既往手术次数(2.07±1.56 与 2.36±2.11,  =.07)或合并症数量(2.39±1.97 与 2.65±1.93, =.09)均无显著差异。此外,在所评估的手术中,没有特定类型的腹部手术可以预测 SBO 时需要手术干预。然而,对于 SBO 后手术和非手术干预,盆腔手术是最常见的既往腹部手术类型(45%与 43%, =.06)。在手术组和非手术组中,女性盆腔手术的比例都明显更高(91.4%与 8.6%, <.0001;89.9%与 10.2%, <.0001)。: 最终,没有特定类型的既往手术可以预测 SBO 时需要手术干预。

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