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Selective use of prophylactic drainage after gastrectomy

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dc.contributor.author이장희-
dc.date.accessioned2018-06-28T07:17:07Z-
dc.date.available2018-06-28T07:17:07Z-
dc.date.issued2018-
dc.identifier.urihttps://ir.ymlib.yonsei.ac.kr/handle/22282913/160042-
dc.descriptionDepartment of Medicine-
dc.description.abstract수술에있어서예방적배액관삽입술의시행유무가환자의수술후합병증에유의미한차이가없다는우리기관의이전연구결과가있었지만현재도대다수의외과의사와기관에서는수술시예방적배액관삽입술을시행하고있다.하지만예방적배액관삽입의유용성은현재까지증명된바가없다. 본연구에서는위암수술시예방적배액관삽입술을시행하지않았던환자를대상으로수술후복강내액체저류로인한경피적배액술을시행했던환자의비율, 특성및위험인자를분석하고자하였다. 방법:2012년1월부터2013년12월까지위암으로위절제술및림프절제술을시행받은1989명의자료를후향적으로분석하여연구를진행하였다. 결과:수술후배액관삽입시술을받은환자의비율은수술시예방적으로배액관을삽입했던환자에서는1.8%(22/1249), 삽입하지않았던환자에서는9.1%(67/740) 이었다. 수술후배액관삽입의독립적인위험인자로는나이(odds ratio [OR], 1.032;p=.013), 남성(ORfor여성, 0.38;p=.005), 개복수술(ORfor최소침습수술, 0.16;p=.013), 수술시간(OR, 1.01;p<.001)이있었다.또한수술후배액관삽입을통해채취한복강내액체를배양한결과, 72.1%(44/61)에서어떠한세균도동정되지않았으며동정되었던세균중에서는Escherichia coli와Candida albicans이가장많은비율을차지하였다. 결론:수술시예방적배액관을삽입하지않는것은수술후배액관삽입시술의가능성을높이지만복강내저류된액체의대부분에서세균은동정되지않았다. 본연구의수술후배액관삽입시술의위험인자분석을통하여필요한환자에게선택적으로예방적배액관을삽입하는것이가능할것으로생각된다.특히probability값이0.09807미만의환자의대부분은실제로수술후예방적배액관이필요하지않을가능성이높았다. (NPV : 96.3%)-
dc.description.statementOfResponsibilityopen-
dc.publisherGraduate School, Yonsei University-
dc.rightsCC BY-NC-ND 2.0 KR-
dc.rightshttps://creativecommons.org/licenses/by-nc-nd/2.0/kr/-
dc.titleSelective use of prophylactic drainage after gastrectomy-
dc.title.alternative위암으로 이한 위절제술 시행 시 예방적 배액관의 선택적 삽입-
dc.typeThesis-
dc.description.degree석사-
dc.contributor.alternativeNameLee, Jang Hee-
dc.type.localThesis-
Appears in Collections:
1. College of Medicine (의과대학) > Others (기타) > 2. Thesis

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