Bowel Obstruction Following Appendectomy What is the True Incidence?
Bowel Obstruction Following Appendectomy What is the True Incidence?
复制标题
DOI：
10.1097/sla.0b013e3181ad64a7
复制
发表时间：
2009-07-01
影响因子：
9
通讯作者：
Maclean, Anthony R.
中科院分区：
文献类型：
--
作者：
Leung, Terry T. W.;Dixon, Elijah;Maclean, Anthony R.
简介：阑尾炎是一种常见的问题，通常是治疗阑尾切除术。腹部手术后，粘连可能形成，并可能导致随后的小肠梗阻（SBO），我们的研究的目的是确定阑尾切除术后SBO在成人人群中的发生率，并观察开腹阑尾切除术与腹腔镜阑尾切除术之间SBO发生率的差异。方法：1999年至2002年期间在卡尔加里卫生区成人医院接受阑尾切除术的所有患者均通过使用行政出院数据库进行识别。回顾了病理和手术技术（腹腔镜，McBurney切口，中线剖腹术）。使用这些地区的健康数字，任何进一步的入院与肠梗阻的诊断代码被确定。对病历（n = 1777）进行了审查，以确认阑尾切除术后SBO的发生率。进行逻辑回归，以确定阑尾切除术后SBO的危险因素，并表示为比值比（95%置信区间）。结果：在平均4.1年的随访期内，总体SBO率为2.8%。阑尾炎切除术后发生SBO的风险因素包括穿孔性阑尾炎（比值比[OR] = 3.1，95%置信区间[CI]：1.5-6.6）和中线切口（OR = 5.4，95% CI：2.8-10.4）。结论：成人阑尾切除术后SBO发生率为2.8%，即0.0069例/人年。发生SBO的最大危险因素是中线切口和非阑尾炎病理。腹腔镜阑尾切除术与开腹阑尾切除术的SBO发生率无统计学显著差异。
Introduction: Appendicitis is a common problem that is typically treated with an appendectomy. Following abdominal Surgery, adhesions may form and may cause a Subsequent small bowel obstruction (SBO), The purpose of Our study was to determine the rate of post-appendectomy SBO in an adult population, and to observe any difference in SBO rates between open versus laparoscopic appendectomies.Methods: All patients who underwent an appendectomy at in adult hospital in the Calgary Health Region between 1999 and 2002 were identified by using the administrative discharge database. Pathology and operative technique (laparoscopic, McBurney incision, midline laparotomy) were reviewed. Using those regional health numbers, any further admissions with a diagnostic code for bowel obstruction were identified. Medical charts (n = 1777) were reviewed to confirm the rate of post-appendectomy SBO. A logistic regression was performed to identify risk factors of post-appendectomy SBO and expressed as odds ratios (95% confidence interval).Results: The overall SBO rate was 2.8% over an average 4.1-year follow-up period. The risk factors for developing SBO following appendectomy for appendicitis included, perforated appendicitis (odds ratio [OR] = 3.1, 95% confidence interval [Cl]: 1.5-6.6), and midline incisions (OR = 5.4, 95% CI: 2.8-10.4). Those with pathology of cancer or chronic appendicitis conferred the greatest overall risk of SBO (OR = 7.4, 95% CI: 2.7-20.31).Conclusions: The rate of SBO following appendectomy ill adults was 2.8%, or 0.0069 cases per person-year. The greatest risk factors for developing SBO were midline incision and nonappendicitis pathology. There is no statistically significant difference in SBO rates following laparoscopic appendectomy compared with open approaches.