Abstract：
BACKGROUND:Few studies have focused on the risk factors for failure to achieve fascial closure after use of negative-pressure wound therapy (NPWT) in an open abdomen (OA). We aimed at analyzing possible risk factors for failure of fascial closure and the risk of fistulas after nontrauma lower gastrointestinal (GI) tract surgery treated with OA. METHODS:This retrospective study included 101 nontrauma patients treated with OA from 2007 to 2011. Multivariate analyses of risk factors were performed. RESULTS:Indications for OA were diffuse peritonitis (n = 47), need for second look (n = 26), failure to achieve fascial closure (e.g., bowel edema) at primary laparotomy (n = 24), and fascial necrosis (n = 4). Of the 101 patients, 61 (60 %) were alive at discharge, with one death possibly related to OA (fistula from an iatrogenic perforation). Delayed fascial closure was obtained in 40 (66 %) of the surviving patients, with 80 % when the indications for OA was need for second look and 72 % in cases of diffuse peritonitis. Compared with need for second look [hazard ratio (HR = 1), 95 % CI], proportional HR for failure of delayed fascial closure were peritonitis 1.96 (1.10-3.49) and failure to achieve fascial closure at primary laparotomy 4.70 (2.17-10.2). In the presence of a stoma the HR was 2.02 (1.13-3.63). CONCLUSIONS:OA using NPWT seems to be a safe procedure, with few procedure-related complications. Failure of fascial closure is related to the indication of OA and the presence of a stoma. Prospective multicenter studies are needed to establish which patients with lower GI surgery benefit from OA.
journal_name
World J Surgjournal_title
World journal of surgeryauthors
Bertelsen CA,Fabricius R,Kleif J,Kristensen B,Gögenur Idoi
10.1007/s00268-013-2360-7subject
Has Abstractpub_date
2014-04-01 00:00:00pages
774-81issue
4eissn
0364-2313issn
1432-2323journal_volume
38pub_type
杂志文章abstract：:In spite of recent therapeutic advances, severe overt secondary hyperparathyroidism due to chronic renal failure necessitates parathyroidectomy and recurrent hyperparathyroidism is one of the most significant problems in this patient population. In the present study, the incidence of recurrent hyperparathyroidism was ...
journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/BF02067331
更新日期：1992-07-01 00:00:00
abstract：:A total of 143 patients who underwent hepatic resection for hepatocellular carcinoma in our department were reviewed. The review was conducted for two periods: 1970-1982 (early period) and 1983-1990 (late period), that is, the periods before and after introduction of the hepatic surgical technique involving the use of...
journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/pl00013167
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
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journal_title：World journal of surgery
pub_type： 杂志文章
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-2963-2
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0377-8
更新日期：2010-06-01 00:00:00
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journal_title：World journal of surgery
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2634-8
更新日期：2014-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
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更新日期：1998-06-01 00:00:00
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journal_title：World journal of surgery
pub_type： 临床试验,杂志文章
doi：10.1007/BF00299089
更新日期：1994-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-014-2775-9
更新日期：2015-04-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1817-4
更新日期：2013-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-015-3157-7
更新日期：2015-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-009-0341-7
更新日期：2010-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05742-5
更新日期：2020-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-012-1664-3
更新日期：2012-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,评审
doi：10.1007/s00268-020-05536-9
更新日期：2020-08-01 00:00:00
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journal_title：World journal of surgery
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更新日期：1993-07-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-020-05912-5
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journal_title：World journal of surgery
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更新日期：2003-02-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
doi：10.1007/s00268-018-4731-6
更新日期：2018-12-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-011-1246-9
更新日期：2011-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-007-9218-9
更新日期：2007-11-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-018-04890-z
更新日期：2019-04-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-013-1959-z
更新日期：2013-05-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
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更新日期：2009-10-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章,随机对照试验
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更新日期：2013-03-01 00:00:00
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journal_title：World journal of surgery
pub_type： 杂志文章
doi：10.1007/s00268-012-1507-2
更新日期：2012-06-01 00:00:00
