低冲击性腹腔镜与尾切除术的常规腹腔镜:一个前性随机试验
Jean-Hubert Etienne1, Benjamin Salucki1,2, Victor Gridel3
1From the Acute Care Surgery (Etienne, Salucki, Baque, Massalou), Centre Hospitalier Universitaire de Nice, Université Côte d'Azur, Nice, France.
Journal of the American College of Surgeons
|June 29, 2023
概括
与传统腹腔镜相比,尾炎的低冲击腹腔镜 (LIL) 显著减少了术后疼痛和住院时间. 这种使用低吸气压和微显微镜的手术方法为患者提供了不那么侵入性的选择.
科学领域:
- 最少侵入性的手术
- 手术创新 在外科创新.
- 胃肠道手术 胃肠道手术
背景情况:
- 低冲击腹腔镜 (LIL) 结合了低压灌气和微腹腔镜.
- 之前没有对LIL进行过急性尾炎管理的评估.
- 本研究评估LIL的可行性和尾切除术的结果.
研究的目的:
- 评估急性尾炎的低冲击腹腔镜 (LIL) 协议的可行性.
- 为了比较术后疼痛,停留时间和LIL和传统腹腔镜之间的止痛药的使用.
- 确定LIL是否比标准腹腔镜尾切除术具有优势.
主要方法:
- 这是一项前性双盲单中心研究,对50名没有并发症的急性尾炎患者进行.
- 患者被随机分配到常规腹腔镜 (12 mmHg灌注) 或LIL (7 mmHg灌注,微腹腔镜仪器).
- 测量结果包括术后疼痛 (VAS),住院时间和住院止痛药消耗.
主要成果:
- 在LIL和传统组之间的并发症率没有显著差异 (p = 0.81).
- 在2小时后,LIL组报告了明显较低的术后疼痛 (p = 0.019).
- LIL协议导致平均逗留时间的统计显著减少 (-0.77天理论上, -0.59天实际上;p < 0.001和p = 0.03).
结论:
- 低冲击性腹腔镜是无并发性急性尾炎的可行方法.
- LIL显著降低了术后疼痛,并缩短了平均停留时间.
- LIL代表了传统的腹腔镜尾切除术的潜在有益的替代方案.
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