手助腹腔镜与开腹结肠切除术 - 美国外科医师学会国家外科质量改进计划程序目标队列的评估

手助腹腔镜与开腹结肠切除术 - 美国外科医师学会国家外科质量改进计划程序目标队列的评估
Hand-assisted laparoscopic vs open colectomy- an assessment from the American College of Surgeons National Surgical Quality Improvement Program procedure-targeted cohort

Abstract
BACKGROUND:
Perioperative outcomes of patients who underwent hand-assisted colorectal laparoscopic (HALS) vs open colectomy were compared using recently released procedure-targeted database.
摘要
背景：
患者行手助腹腔镜结直肠癌根治术围手术期的结果（HALS）与开放手术的使用最近发布的程序有针对性的数据库进行比较。

METHODS:
Review was conducted using the 2012 colectomy-targeted American College of Surgeons National Surgical Quality Improvement Program database. Patients were classified into 2 groups according to final surgical approach: HALS vs open (planned). Groups were matched (1:1) based on age, gender, body mass index, surgical procedure, diagnosis, American Society of Anesthesiologists score, and wound classification. Multivariate logistic regression analysis was conducted for group comparison.
方法：
审查采用外科手术国家质量改进计划数据库的2012结肠靶向美国大学进行。根据最终的手术方法患者分为2组：HALS VS开放的（计划）。组相匹配（1：1）根据年龄，性别，身体质量指数，手术，诊断，美国麻醉医师协会得分，和伤口分类。是为组进行比较，多因素Logistic回归分析。

RESULTS:
Of 7,303 patients, 1,740 patients were matched in each group. Open group had higher proportion of patients with preoperative dyspnea (P = .01), ascites (P = .01), weight loss (P < .001), smoking history (P = .04), and increased work relative value units (P < .001). After adjusting for difference in baseline comorbidities, overall morbidity, superficial, deep, and organ-space surgical site infection, urinary tract infection, ileus, reoperation, readmission, and hospital stay were significantly higher in open group (P < .05).
结果：
7303名患者中，1740例患者各组相匹配。打开组患者术前呼吸困难（P = 0.01），腹水（P= 0.01），体重下降（P <0.001），吸烟史（P =0.04），并增加了工作相对价值单位的比例较高（P <0.001）。调整基线合并症，整体发病率，浅深和器官空间外科手术部位感染，尿路感染，肠梗阻，再次手术，再次入院，住院时间差后在公开组（P <0.05）显著高。

CONCLUSIONS:
National Surgical Quality Improvement Program targeted-data demonstrated several advantages of HALS compared with open colonic resection including shorter hospital stay and lower complication rate. Further adoption of HALS technique as a bridge to straight laparoscopy or tool in difficult cases can positively impact the short-term outcomes after colectomy when compared with open technique.
结论：
国家外科质量改进计划的目标数据显示HALS几个优势与开放结肠切除术包括缩短住院时间，降低并发症发生率的比较。HALS技术进一步在困难的情况下，直接采用腹腔镜或工具的桥梁可以积极影响短期疗效与开放技术相比，结肠切除术后。

KEYWORDS:
Colorectal surgery; Hand-assisted laparoscopic surgery; NSQIP; Procedure-targeted database
关键词：
结直肠手术；手辅助腹腔镜手术；计划；有针对性的数据库

英文原文：
Hand-assisted laparoscopic vs open colectomy- an assessment from the American Co.pdf (278.31 KB, 下载次数: 0, 售价: 99 香叶)

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手助腹腔镜与开腹结肠切除术 - 美国外科医师学会国家外科质量改进计划程序目标队列的评估