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脾切除术的术后结果:哥伦比亚 20 年单中心经验。

Postoperative outcomes after splenectomy: a 20-year single-center experience in Colombia.

机构信息

Estudiante de posgrado Cirugía General, Facultad de Medicina, Pontificia Universidad Javeriana, Carrera 6A #51A-48, Bogotá, D.C., 111711, Colombia.

Cirujano General, Facultad de Medicina, Pontificia Universidad Javeriana, Bogotá, Colombia.

出版信息

BMC Surg. 2024 Nov 16;24(1):362. doi: 10.1186/s12893-024-02637-3.

Abstract

BACKGROUND

Splenectomy indications are well documented; however, several infectious complications and potentially life-threatening conditions could arise after splenectomy. We aim to describe a 20-year single-center experience of postoperative outcomes after splenectomy and perform a subgroup analysis according to approach and surgical setting with a 30-day, 90-day, and 1-year follow-up.

STUDY DESIGN

A retrospective cohort study was conducted between 2003 and 2023. We included all patients aged 18 years and older who underwent splenectomy. A description of clinical and operative variables with infectious outcomes was performed. Subgroup analyses were performed between open or laparoscopic approach and surgical setting.

RESULTS

A total of 134 patients were included. Female patients constituted 52.99% (n = 71) of cases, with a mean age of 51.01 ± 20.79 years. The most frequent surgical indication for splenectomy was trauma in 31.34% (n = 42), and a laparoscopic approach was indicated in 41.79% (n = 56). Overwhelming post-splenectomy syndrome (OPSI) was evidenced in 2.24% (n = 3) of the population. Surgical characteristics such as operative time, intraoperative blood loss, and intensive care requirement and unit length of stay were higher in open and trauma patients.

CONCLUSION

Our data describe the demographic, clinical and operative characteristics of patients undergoing splenectomy in Colombia, providing a solid basis for future research. The results obtained on overwhelming postsplenectomy syndrome (OPSI) and postoperative complications are comparable with those reported in the international literature, reinforcing the validity of our findings. Further prospective studies in this population are needed to optimize management strategies and improve clinical outcomes, particularly in higher risk subgroups.

摘要

背景

脾切除术的适应证已有充分记录;然而,脾切除术后可能会出现几种感染性并发症和潜在的危及生命的情况。我们旨在描述 20 年来单中心脾切除术后结局的经验,并根据手术方式和手术环境进行亚组分析,随访时间为 30 天、90 天和 1 年。

研究设计

这是一项回顾性队列研究,于 2003 年至 2023 年进行。我们纳入了所有年龄在 18 岁及以上接受脾切除术的患者。对临床和手术变量与感染结果进行了描述。在开放或腹腔镜手术方式和手术环境之间进行了亚组分析。

结果

共纳入 134 例患者。女性患者占 52.99%(n=71),平均年龄为 51.01±20.79 岁。脾切除术最常见的手术指征是创伤,占 31.34%(n=42),腹腔镜手术指征占 41.79%(n=56)。有 2.24%(n=3)的人群出现了脾切除术后凶险性感染(OPSI)。开放和创伤患者的手术特征,如手术时间、术中失血量、需要重症监护和住院时间,均较高。

结论

我们的数据描述了哥伦比亚接受脾切除术患者的人口统计学、临床和手术特征,为未来的研究提供了坚实的基础。我们在脾切除术后凶险性感染(OPSI)和术后并发症方面的结果与国际文献报道的结果相当,证实了我们研究结果的有效性。需要在该人群中开展进一步的前瞻性研究,以优化管理策略并改善临床结局,特别是在高风险亚组中。

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