Operative blood loss and use of blood products after laparoscopic and conventional open colorectal operations
Operative blood loss and use of blood products after laparoscopic and conventional open colorectal operations
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DOI：
10.1001/archsurg.139.1.39
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发表时间：
2004-01-01
影响因子：
--
通讯作者：
Fazio, VW
中科院分区：
文献类型：
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作者：
Kiran, RP;Delaney, CP;Fazio, VW
假设：与传统开腹结肠切除术患者相比，接受腹腔镜结肠切除术的患者的失血量较少。设计：病例匹配研究。背景：一所大学医院。患者：在前瞻性数据库中，2000年1月至2001年12月接受腹腔镜结肠切除术的患者与同期行开腹结肠切除术的患者在年龄、性别、合并症和手术方式等方面进行匹配。主要观察指标：比较术后估计的失血量、血红蛋白水平下降和输血需求。结果：147名接受相同手术的患者在年龄、性别、合并症和手术操作方面与同期的开腹结肠切除术患者相匹配。性别，和诊断相关的分组。美国麻醉医师学会的等级、体重指数或手术前后的血红蛋白水平没有显著差异，但开放结肠切除术组需要显著更多的血液单位(P=0.003)以维持手术后相似的血红蛋白水平。估计失血量(P
Hypothesis: Blood loss, measured by estimated blood loss, drop in hemoglobin levels, and transfusion requirements, is lower in patients undergoing laparoscopic colectomy compared with patients undergoing conventional open colectomy.Design: Case-matched study.Setting: A university hospital.Patients: Patients undergoing laparoscopic colectomy between January 2000 and December 2001 were matched in a prospective database for age, sex, comorbidity, and surgical procedure with patients undergoing open colectomy during the same period.Main Outcome Measures: Estimated blood loss, drop in hemoglobin levels, and transfusion requirements after surgery were compared.Results: One hundred forty-seven patients undergoing the same operation using either an open or laparoscopic approach could be matched for age, sex, and diagnosis related grouping. there was no significant difference in American Society of Anesthesiologists class, body mass index, or preoperative and postoperative hemoglobin levels, but the open colectomy group required significantly more units of blood (P = .003) to maintain similar hemoglobin levels after surgery. Estimated blood loss (P