一项对腹腔镜和开放外科手术方法进行穿孔性胃潰瘍修复的比较研究:疗效和结果分析
Zi-Wei Li1, Yue Tong1, Fei Liu1
1Department of Gastrointestinal Surgery, the First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Langenbeck's archives of surgery
|November 14, 2023
概括
与开放式修复相比,对于胃潰瘍穿孔 (PPU) 的腹腔镜修复显示出较低的死亡率和较少的并发症,如肺炎和伤口感染. 这表明腹腔镜手术可能是PPU治疗的优越选择.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 临床结果研究研究
背景情况:
- 胃潰瘍穿孔 (PPU) 是需要手術的嚴重疾病.
- 传统的开放性手术一直是标准的治疗方法,但最少的侵入性技术正在发展.
研究的目的:
- 为了比较腹腔镜与腹腔 perforation (PPU) 的开放修复的临床结果.
主要方法:
- 从PubMed,EMBASE和Cochrane图书馆发表的研究的系统审查和元分析,截至2023年3月31日.
- 包括29项研究,包括17228名患者.
- 使用几率比率 (OR) 和95%信心区间 (CI) 的统计分析,通过纽卡斯尔-太华量表 (NOS) 和Stata软件进行质量评估.
主要成果:
- 与开放式修复相比,腹腔镜修复与住院时间显著缩短,血液流失减少,伤口感染和肺炎减少有关.
- 腹腔镜组显示呼吸道并发症和整体术后发病率较低.
- 最重要的是,腹腔镜修复显示的死亡率明显低 (OR=0.36,95%CI=0.27-0.49) 和整体并发症率较低 (OR=0.45,95%CI=0.34-0.60),而不是开放修复.
结论:
- 对PPU进行 laparoscopic 修复与降低死亡风险和改善术后结果有关.
- 这些发现支持腹腔镜修复作为患有胃潰瘍穿孔的患者潜在的更好的手术选择.
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