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胰腺切除后的早期或晚期排水 - - 一个系统的审查和元分析
Andrew Guan Ru Wu1, Ramkumar Mohan2, Khi Yung Fong1
1Yong Loo Lin School of Medicine, National University of Singapore, Singapore, Singapore.
Langenbeck's archives of surgery
|August 16, 2023
概括
在胰腺手术后提前清除排水,显著降低了临床相关的手术后胰腺 (CR-POPF) 和其他并发症的风险. 这一策略还导致了更短的住院时间和更少的再入院.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 临床试验 临床试验
背景情况:
- 临床相关的手术后胰腺 (CR-POPF) 是胰腺切除后的一个主要并发症.
- 优化术后排水管理是减轻这种风险的关键策略.
研究的目的:
- 为了评估早期和后期手术后排水处理对CR-POPF发病率的影响.
- 评估排水时间和其他术后并发症之间的关联.
主要方法:
- 对9项涉及胰腺切除 (胰腺二切除和远端胰腺切除) 的研究进行了系统审查和元分析.
- 早期排水 (≤3 POD) 与晚期排水 (>3 POD) 的比较.
- 主要结局:CR-POPF (ISGPS等级B或更高);次要结局:各种并发症,停留时间,再入院,死亡率.
主要成果:
- 早期排水与显著降低CR-POPF风险相关 (OR:0.24,p <0.01).
- 观察到术后出血,腹腔内感染,再入院,重复手术和早期切除的整体并发症的显著减少.
- 早期排水还导致住院时间缩短 (SMD: -0.75,p < 0.01).
结论:
- 提前清除排水与CR-POPF和其他术后并发症的显著减少有关.
- 建议进一步进行前性随机试验,以证实这些发现.
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