拉皮眼腹膜洗或腹膜切除术用于性腹膜炎的穿孔分泌体炎:多中心,并行组,随机,开放试验
Sandra Vennix1, Gijsbert D Musters2, Irene M Mulder3
1Department of Surgery, Academic Medical Center, Amsterdam, Netherlands; Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands.
在治疗性穿孔膜炎方面, laparoscopic 洗并不优于 sigmoidectomy. 这种手术方法在随机试验中没有显示出更好的长期结果.
科学领域:
- 胃肠病学
- 外科创新
- 临床试验
背景情况:
- 穿孔性垂炎是一种常见的需要手术的疾病.
- laparoscopic 腹腔清洗已被提议作为一个不那么侵入性的替代方案.
- 对于性穿孔膜炎,比较这些方法的证据有限.
研究的目的:
- 为了比较腹腔镜洗与西格莫切除术在性穿孔膜炎患者中的疗效.
- 评估腹腔镜洗在整体长期发病率和死亡率方面的优势.
主要方法:
- 进行了一项多中心,并行组,随机,开放的试验 (女性试验,LOLA部分).
- 患有性穿孔膜炎的患者被随机分配到腹腔镜洗或西格莫切除术 (2:1:1比率).
- 主要终点是12个月内主要发病率和死亡率的组合.
主要成果:
- 由于洗组的发病率增加,该研究提前结束.
- 主要终点发生在67%的洗组和60%的西格莫切除组 (p=0. 58).
- 在12个月的死亡率在两组之间是相似的 (洗后4例死亡,西格莫切除术后6例死亡).
结论:
- 在治疗性穿孔膜炎方面, laparoscopic 洗并不优于 sigmoidectomy.
- 在这种患者群体中,观察到的事件发生率表明了腹腔镜洗的潜在风险.
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