成年人的椎修复:一个随机,双盲,受控的多中心试验
Ruth Kaufmann1, Jens A Halm2, Hasan H Eker3
1Department of Surgery, Erasmus University Medical Center, Rotterdam, Netherlands; Department of Surgery, Albert Schweitzer Hospital, Dordrecht, Netherlands.
Lancet (London, England)
|February 21, 2018
概括
与传统修复相比,网状修复显著降低了较小的椎 (1-4厘米直径) 的复发率. 这项研究提供了高水平的证据,支持对这些常见的腹壁缺陷的使用.
科学领域:
- 外科手术
- 胃肠病学
- 医疗工程
背景情况:
- 椎是常见的,使用网状和状修复技术.
- 在较小的椎 (1-4厘米) 中,有较少的证据表明网状优势.
- 这项研究涉及小椎的网状和修复的比较疗效.
研究的目的:
- 调查网状修复是否优于修复,以减少较小的椎 (1-4厘米直径) 的复发率.
主要方法:
- 一个随机的,双盲的,受控的多中心试验,涉及300名患有主要椎间 (1-4厘米) 的成年患者.
- 患者被随机分配 (1:1) 进行手术内网状修复或 suture修复.
- 随访包括体检和超声波检查,在24个月后评估复发率.
主要成果:
- 在24个月后,与 suture (12%) 相比,mesh修复的复发率显著减少 (p=0. 01).
- 两年的保险学复发率为3.6%的网格,而线修复为11.4%.
- 像血清瘤这样的术后并发症稍微更常见,但整体并发症率较低,没有死亡.
结论:
- 这项研究提供了高水平的证据,表明网状修复在小椎 (1-4厘米) 方面比修复更有效.
- 在此尺寸范围内进行椎的手术建议修复网状.
- 这些发现支持对较小椎的网状利用的转变.
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