目的:比较有和没有烟草使用史的Zenker憩室切开术(ZD)患者的临床结果。
方法:单机构回顾性审查。
方法:三级护理学术医院。
方法:回顾性回顾通过开式吻合器接受ZD的患者,刚性内窥镜CO2激光,订书机或谐波手术刀,2006年1月至2020年12月进行了柔性内镜技术.数据是根据患者的人口统计学提取的,憩室特征,以及不良事件和症状性复发率。
结果:在424例患者中,146(34.4%)有烟草使用史:126(29.7%)是以前的吸烟者,20名(4.7%)是活跃吸烟者。在单变量横截面分析中,术后出血的可能性,穿孔,急诊部门的访问,计划外的重新接纳,即使在调整年龄后,或复发也没有显示出与烟草使用史的关联,性别,和手术方法。同样,在Cox比例危险回归中,烟草使用与复发风险增加无关,即使在校正了年龄之后,性别,和手术类型。在我们的队列中,非吸烟者的中位复发时间为11.5年,8.7年的前吸烟者,活跃吸烟者为1.2年(p=0.94)。
结论:在ZD的术后不良事件或复发频率方面,前者,和非吸烟者。尽管动力不足且没有统计学意义,与手术后的既往吸烟者和非吸烟者相比,吸烟者的中位复发时间似乎更短.
OBJECTIVE: To compare clinical outcomes in patients with and without history of tobacco use who underwent Zenker\'s diverticulotomy (ZD).
METHODS: Single institution retrospective review.
METHODS: Tertiary care academic hospital.
METHODS: A retrospective review of patients who underwent ZD via an open stapler, rigid endoscopic CO2 laser, stapler or harmonic scalpel, and flexible endoscopic technique from January 2006 to December 2020 was performed. Data were abstracted for patient demographics, diverticular features, and rates of adverse events and symptomatic recurrence.
RESULTS: Out of 424 patients, 146 (34.4 %) had a history of tobacco use: 126 (29.7 %) were former smokers, and 20 (4.7 %) were active smokers. In univariable cross-sectional analyses, the likelihood of postoperative bleeding, perforation, emergency department visits, unplanned readmission, or recurrence did not demonstrate an association with tobacco use history even after adjustment for age, sex, and surgical approach. Similarly, in Cox Proportional Hazards regression, tobacco use was not associated with an increased risk of recurrence, even after correcting for age, sex, and type of surgery. The median time to recurrence observed in our cohort was 11.5 years amongst non-smokers, 8.7 years amongst former smokers, and 1.2 years amongst active smokers (p = 0.94).
CONCLUSIONS: There were no significant differences in post-operative adverse events or frequency of recurrence of ZD between active, former, and non-smokers. Although underpowered and not statistically significant, median time to recurrence appears to be shorter in smokers when compared with former and non-smokers following surgery.