对于急性尾炎成年患者的延迟或早期腹腔镜尾切除术:一项随机对照试验
Sunil V Patel1, Lisa Zhang1,2, Zuhaib M Mir1
1Department of Surgery, Queen's University, Kingston General Hospital, Kingston, ON, Canada.
Annals of surgery
|July 12, 2023
概括
将急性尾炎的手术推迟到早上是安全有效的. 德莱试验发现,延迟尾切除术的患者在晚上呈现并没有增加术后并发症,证明不劣于立即手术.
科学领域:
- 手术成果研究的研究结果.
- 紧急医疗 紧急医疗
- 临床试验方法论 临床试验方法论
背景情况:
- 急性尾炎是一种常见的手术紧急情况.
- 晚上出现的患者经常经历延迟尾切除术,没有明确的证据.
研究的目的:
- 评估将尾切除术推迟到早上是否与夜间急性尾炎的立即手术无差.
- 为了评估30天的术后并发症延迟与即时尾切除.
主要方法:
- 一项非劣势随机对照试验 (DELAY试验) 涉及已确认晚间出现急性尾炎的成年人.
- 延迟手术 (上午6点后) 与立即手术的比较.
- 主要结局:经过30天的术后并发症;非劣势率设置为15%.
主要成果:
- 招募了127名患者,59名患者在延迟手术组,68名患者在立即手术组.
- 术后并发症发生在10.2%的延迟组和22.4%的即时组 (P=0.07) 中.
- -12.2%的风险差异符合非劣势标准 (95% CI: -24.4%至 +0.4%).
结论:
- 推迟晚上出现的急性尾炎的尾切除术与立即手术无差.
- 这项DELAY研究提供了第一个支持该患者群体延迟尾切除的试验证据.
- 随着手术推迟,没有观察到术后并发症的增加.
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