Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database.
Laparoscopic Surgery for Acute Diffuse Peritonitis Due to Gastrointestinal Perforation: A Nationwide Epidemiologic Study Using the National Clinical Database.
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DOI：
10.1002/ags3.12533
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发表时间：
2022-05
影响因子：
2.7
通讯作者：
中科院分区：
文献类型：
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作者：
择期腹腔镜手术因其创伤小、术后恢复快等优点，在腹部疾病的治疗中被广泛接受。它还用于急诊诊断和治疗急性弥漫性腹膜炎，而不考虑病因。然而，腹腔镜在急性弥漫性腹膜炎中的价值仍不清楚。在这项研究中，我们旨在显示随着时间的推移，腹腔镜术的使用趋势，并比较腹腔镜术和开腹手术治疗胃肠道穿孔所致的急性弥漫性腹膜炎的实际效果。我们从日本全国性的外科注册系统国家临床数据库中提取了2016至2019年间因胃十二指肠或结直肠穿孔而被诊断为急性弥漫性腹膜炎的患者的数据。随着时间的推移，确定了使用腹腔镜检查的趋势。比较了腹腔镜术和开腹手术的患者特征、实验室检查结果、手术结果和术后并发症。病情较差和实验室检查异常的患者倾向于接受开放手术。胃十二指肠穿孔患者腹腔镜手术麻醉时间和手术时间较长，而结直肠穿孔患者较短。接受腹腔镜手术的患者并发症较少。随着时间的推移，进行腹腔镜手术的机构数量和每个机构使用腹腔镜术的比例都在增加。在胃肠道穿孔所致的急性弥漫性腹膜炎的外科手术中，腹腔镜的使用越来越普遍。对于急性弥漫性腹膜炎，这种方法可能是一种有用的选择。由于胃肠道穿孔导致的急性弥漫性腹膜炎，腹腔镜手术正变得越来越普遍。尽管急诊腹腔镜手术的候选人数可能有限，但对于急性弥漫性腹膜炎来说，腹腔镜手术可能是一种有用的选择。
Elective laparoscopic surgery is now widely accepted in the treatment of abdominal diseases because of its minimal invasiveness and rapid postoperative recovery. It is also used in the emergency setting for the diagnosis and treatment of acute diffuse peritonitis regardless of the causative disease. However, the value of laparoscopy in acute diffuse peritonitis remains unclear. In this study we aimed to show trends in the use of laparoscopy over time and compare the real‐world performance of laparoscopic surgery with that of open surgery for acute diffuse peritonitis due to gastrointestinal perforation. We extracted data from the National Clinical Database, a nationwide surgery registration system in Japan, for patients with a diagnosis of acute diffuse peritonitis due to gastroduodenal or colorectal perforation between 2016 and 2019. Trends in the use of laparoscopy over time were identified. Patient characteristics, laboratory findings, surgical findings, and postoperative complications were compared between laparoscopic surgery and open surgery. Patients in poor condition and those with abnormal laboratory findings tended to undergo open surgery. Anesthesia time and operating time were longer for laparoscopic surgery in patients with gastroduodenal perforation but shorter in those with colorectal perforation. Fewer complications occurred in patients who underwent laparoscopic surgery. The number of institutions where laparoscopic surgery was performed and the proportion of the use of laparoscopy at each institution increased over time. The use of laparoscopy is becoming common in surgery for acute diffuse peritonitis due to gastrointestinal perforation. This approach may be a useful option for acute diffuse peritonitis. Laparoscopic surgery is becoming common for acute diffuse peritonitis due to gastrointestinal perforation. Although the number of candidates for emergency laparoscopic surgery might be limited, laparoscopic surgery may be a useful option for acute diffuse peritonitis.
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影响因子：
2.7
作者：
Hasegawa H;Takahashi A;Kanaji S;Kakeji Y;Marubashi S;Konno H;Gotoh M;Miyata H;Kitagawa Y;Seto Y
通讯作者：
Seto Y
影响因子：
4.3
作者：
Jimenez Rodriguez, Rosa M.;Jose Segura-Sampedro, Juan;Padillo Ruiz, Javier
通讯作者：
Padillo Ruiz, Javier
DOI：
10.1007/s004640000022
发表时间：
2000-05-01
期刊：
SURGICAL ENDOSCOPY-ULTRASOUND AND INTERVENTIONAL TECHNIQUES
影响因子：
--
作者：
Agresta, F;Michelet, I;Bedin, N
通讯作者：
Bedin, N
影响因子：
2.6
作者：
Patel, Richa;Patel, Krishan S.;Merchant, Aziz M.
通讯作者：
Merchant, Aziz M.
在日本国家临床数据库中，由于不同医院的结直肠穿孔而引起的外科手术死亡率与10,090例病例的数据进行了比较。
影响因子：
1.6
作者：
Ohki T;Yamamoto M;Miyata H;Sato Y;Saida Y;Morimoto T;Konno H;Seto Y;Hirata K
通讯作者：
Hirata K