博尔哈弗综合征手术治疗的过去、现在和未来:一个专门手术室的最新成果。

IF 1.1 4区 医学 Q3 SURGERY Annals of the Royal College of Surgeons of England Pub Date : 2024-07-01 Epub Date: 2024-04-02 DOI:10.1308/rcsann.2024.0020
T Triantafyllou, P Lamb, R Skipworth, G Couper, C Deans
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引用次数: 0

摘要

简介波尔哈韦综合征是一种罕见的临床症状,发病率和死亡率都很高。早期发现症状、确定损伤部位和扩展范围是改善预后的关键:本研究提供了被诊断为博尔哈弗综合征患者的死亡率、发病率和住院时间数据。这些数据取自 2012 年至 2022 年期间在一个外科单元的前瞻性数据库中收集的数据。研究结果与前十年的手术结果进行了比较:结果:2012年至2022年期间,约有33名患者被诊断出患有布尔哈韦综合征,并在一家专科上消化道手术室接受了手术治疗。所有患者均接受了标准手术修复(手术室内诊断性内窥镜检查、通过胸腔切开术置入T型管、通过腹腔切开术进行空肠进食)。食管腔内缺损的平均大小为 3.3 厘米。有13名患者(39%)延误了治疗,8名患者(24%)在住院期间死亡,19名患者(58%)出现了术后并发症。死亡率与前十年20名患者的死亡率相似(分别为24%和20%)。平均住院时间为41天,与1997年至2011年间报告的35.7天相当:结论:早期积极治疗自发性食管破裂可改善术后恢复和预后。在接受手术治疗的患者群体中,我们科室的手术效果与前十年相当。
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Surgical treatment of Boerhaave syndrome in the past, present and future: updated results of a specialised surgical unit.

Introduction: Boerhaave syndrome is a rare clinical entity associated with high rates of morbidity and mortality. Early recognition of the symptoms, and identification of the site and extension of the injury are key in improving the prognosis.

Methods: This study presents data on the mortality, morbidity and length of hospital stay in patients diagnosed with Boerhaave syndrome. The data were retrieved from a prospectively collected database in a single surgical unit between 2012 and 2022. The study makes a comparison with the surgical outcomes of the previous decade.

Results: Some 33 patients were diagnosed with Boerhaave syndrome and were treated surgically between 2012 and 2022 in a specialist upper gastrointestinal surgical unit. All patients underwent standard surgical repair (in-theatre diagnostic endoscopy, T-tube placement through thoracotomy and feeding jejunostomy through laparotomy). The mean size of the defects in the oesophageal lumen was 3.3cm. Delayed presentation was noted for 13 patients (39%); 8 patients (24%) died in hospital, and 19 patients (58%) developed postoperative complications. Mortality was similar to the rate recorded for the 20 patients from the previous decade (24% vs 20%, respectively). The mean length of hospital stay was 41 days, and was comparable to the 35.7 days reported between 1997 and 2011.

Conclusions: Early and aggressive management of spontaneous oesophageal rupture ameliorates the postoperative recovery and prognosis. The surgical results of our unit were found comparable to the previous decade in the population of patients who were treated surgically.

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来源期刊
CiteScore
2.40
自引率
0.00%
发文量
316
期刊介绍: The Annals of The Royal College of Surgeons of England is the official scholarly research journal of the Royal College of Surgeons and is published eight times a year in January, February, March, April, May, July, September and November. The main aim of the journal is to publish high-quality, peer-reviewed papers that relate to all branches of surgery. The Annals also includes letters and comments, a regular technical section, controversial topics, CORESS feedback and book reviews. The editorial board is composed of experts from all the surgical specialties.
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