与选择性切割修复相关的长期复发和并发症
Dunja Kokotovic1, Thue Bisgaard2, Frederik Helgstrand3
1Center for Surgical Science, Zealand University Hospital, Køge, Denmark.
JAMA
|October 19, 2016
概括
切口的假网修复减少了复发风险,但增加了长期的网状并发症. 这项研究比较了网状与非网状修复,发现网状修复降低了复发率,但也带来了风险.
科学领域:
- 腹部手术
- 的修复
- 在手术中的生物材料
背景情况:
- 假肢网被广泛用于切口修复.
- 包括复发率和并发症在内的长期益处和风险尚未得到充分了解.
研究的目的:
- 在选择性腹壁修复后调查复发和网状相关并发症的长期风险.
- 为了比较网格修复 (开放式和腹腔镜) 与非网格修复的结果.
主要方法:
- 在丹麦进行切口修复的3242名患者的全国性队列研究 (2007-2010).
- 在2014年11月之前与国家登记处进行数据链接和手动记录审查,以实现100%的后续工作.
- 在开放网格,腹腔镜网格和开放非网格修复技术之间比较5年复发率和网格并发症率.
主要成果:
- 与非网格修复相比,网格修复 (开放式和腹腔镜) 与的复发风险较低 (10. 6% - 12. 3% 与17. 1% 相比).
- 在5年内,累积的网状复杂症为开放网状复杂症的5. 6%和腹腔镜网状复杂症的3. 7%.
- 与非网格修复相比,与修复相关的并发症发生率显著降低 (0.8%).
结论:
- 虽然网格修复减少了的复发,但这些好处被长期网格相关并发症的风险增加所抵消.
- 在网格和非网格修复之间做出选择需要平衡复发风险和潜在的并发症.
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