Increased morbidity in combined abdominal sacrocolpopexy and abdominoplasty procedures.
Increased morbidity in combined abdominal sacrocolpopexy and abdominoplasty procedures.
复制标题
腹部骶骨固定术和腹部成形术联合手术的发病率增加。
DOI：
10.1007/s00192-012-1857-1
复制
发表时间：
2013
影响因子：
1.8
通讯作者：
Gutman,RE
中科院分区：
文献类型：
--
作者：
Meriwether,KV;Antosh,DD;Knoepp,LR;Chen,CCG;Mete,M;Gutman,RE
介绍和假设本研究旨在确定与单独使用ASC相比，腹部成形术联合腹部骶骨阴道固定术（ASC + A）是否会增加围手术期发病率。我们假设，接受联合手术的患者会增加complication.MethodsThis是一个多中心，回顾性队列研究的所有妇女接受ASC + A从2002年至2010年在华盛顿医院中心和约翰霍普金斯大学。我们选择了两名单独接受ASC的妇女与每个ASC + A患者进行比较。记录基线人口统计学、手术数据、住院时间和围手术期并发症。主要结局是手术后6周内的任何重大并发症，包括术中并发症、肺栓塞（PE）、深静脉血栓形成（DVT）、心脏损害、重症监护室（ICU）入院、再次手术和再次入院。手术数据和轻微并发症也compared.Results26 ASC + A患者和52 ASC患者被确定。组间基线特征无显著差异。ASC + A患者的手术时间较长（337 vs 261 min，p< 0.01），术中静脉输液较多（4，665 vs 3181 ml，p< 0.01），住院时间较长（3.7 vs 2.7 d，p< 0.01）。ASC + A组有23%的患者发生严重并发症，而ASC组为12%（p= 0.20）。ASC + A组有更大的下降，红细胞压积水平和PE，ICU入院率较高，输血，所有这些都有统计学意义。ConclusionsASC + A增加住院时间和围手术期并发症，如PE，ICU入院，输血，与ASC单独。由于联合手术的发病风险增加，外科医生应考虑推荐间隔腹壁成形术。
Introduction and hypothesisThis study was performed to determine whether abdominoplasty combined with abdominal sacrocolpopexy (ASC + A) increases perioperative morbidity compared with ASC alone. We hypothesized that patients undergoing combined procedures would have increased complications.MethodsThis was a multicenter, retrospective cohort study of all women undergoing ASC + A from 2002 to 2010 at Washington Hospital Center and Johns Hopkins University. We selected two women undergoing ASC alone for comparison with each ASC + A patient. Baseline demographics, surgical data, length of hospitalization, and perioperative complications were recorded. The primary outcome was any major complication within 6 weeks of surgery, including intraoperative complications, pulmonary embolism (PE), deep venous thrombosis (DVT), cardiac compromise, intensive care unit (ICU) admission, reoperation, and readmission. Surgical data and minor complications were also compared.ResultsTwenty-six ASC + A patients and 52 ASC patients were identified. There were no significant differences in baseline characteristics between groups. Patients with ASC + A had longer operating times (337 vs 261 min,p< 0.01), more intravenous fluid administration intraoperatively (4,665 vs 3181 ml,p< 0.01), and longer hospital stays (3.7 vs 2.7 days,p< 0.01). Major complications occurred in 23 % of the ASC + A group compared with 12 % of the ASC group (p= 0.20). The ASC + A group had greater declines in hematocrit levels and higher rates of PE, ICU admission, and blood transfusion, all of which were statistically significant.ConclusionsASC + A increases length of stay and perioperative complications, such as PE, ICU admission, and blood transfusion, compared with ASC alone. Surgeons should consider recommending interval abdominoplasty due to increased morbidity risk with a combined procedure.