دورية أكاديمية
Acute Colonic Pseudo-obstruction: Colonoscopy Versus Neostigmine First?
العنوان: | Acute Colonic Pseudo-obstruction: Colonoscopy Versus Neostigmine First? |
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المؤلفون: | Williamson S; Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Tower Health System, Reading, Pennsylvania. Electronic address: Sigrid.Williamson@towerhealth.org., Muller A; Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Tower Health System, Reading, Pennsylvania., Butts CA; Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Tower Health System, Reading, Pennsylvania., Geng TA; Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Tower Health System, Reading, Pennsylvania., Ong AW; Division of Trauma and Critical Care, Department of Surgery, Reading Hospital, Tower Health System, Reading, Pennsylvania. |
المصدر: | The Journal of surgical research [J Surg Res] 2023 Aug; Vol. 288, pp. 38-42. Date of Electronic Publication: 2023 Mar 20. |
نوع المنشور: | Journal Article |
اللغة: | English |
بيانات الدورية: | Publisher: Academic Press Country of Publication: United States NLM ID: 0376340 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1095-8673 (Electronic) Linking ISSN: 00224804 NLM ISO Abbreviation: J Surg Res Subsets: MEDLINE |
أسماء مطبوعة: | Publication: New York, NY : Academic Press Original Publication: Philadelphia [etc.] |
مواضيع طبية MeSH: | Neostigmine*/therapeutic use , Colonic Pseudo-Obstruction*/therapy , Colonic Pseudo-Obstruction*/surgery, Humans ; Retrospective Studies ; Colonoscopy ; Treatment Outcome ; Acute Disease |
مستخلص: | Introduction: Neostigmine (NEO) and decompressive colonoscopy (COL) are two efficacious treatment modalities for acute colonic pseudo-obstruction (ACPO). We hypothesize that a COL first strategy is associated with better outcomes compared to a NEO first strategy. Methods: A single-center retrospective analysis was performed from 2013 to 2020. Patients ≥18 y with a diagnosis of ACPO were included. The outcome was a composite measure of acute operative intervention, 30-day readmission with ACPO, and 30-day ACPO-related mortality. A P-value of ≤ 0.05 indicated statistical significance. Results: Of 910 encounters in 849 patients, 50 (5.5%) episodes of ACPO in 39 patients were identified after exclusion of one patient with colon perforation on presentation. The median (interquartile range) age was 68 (62-84) y. NEO and COL were administered in 21 and 25 episodes, respectively. In 16 (32%) episodes, no NEO or COL was administered. When patients were given NEO first, COL or additional NEO was required in 12/18 (67%) compared with a COL first strategy where a second COL and/or NEO was given in 5/16 (32%) (P = 0.05). Both strategies had similar outcomes (NEO, 4/18 versus COL, 4/16, P = 0.85). Twenty-two (44%) episodes had an early intervention (≤48 h) with NEO and/or COL. There was no difference in outcome between those that received an early intervention and those who did not (5/22 versus 5/28, P = 0.71). Conclusions: For patients failing conservative measures, a COL first approach was associated with fewer subsequent interventions, but with similar composite outcomes compared to a NEO first approach. Early (≤48 h) intervention with NEO and/or COL was not associated with improved outcomes. (Copyright © 2023 Elsevier Inc. All rights reserved.) |
فهرسة مساهمة: | Keywords: Acute colonic pseudo-obstruction; Decompressive colonoscopy; Neostigmine; Ogilvie's syndrome |
المشرفين على المادة: | 3982TWQ96G (Neostigmine) |
تواريخ الأحداث: | Date Created: 20230322 Date Completed: 20230515 Latest Revision: 20230531 |
رمز التحديث: | 20240628 |
DOI: | 10.1016/j.jss.2023.02.023 |
PMID: | 36948031 |
قاعدة البيانات: | MEDLINE |
تدمد: | 1095-8673 |
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DOI: | 10.1016/j.jss.2023.02.023 |