预防性网状增大在紧急腹腔切除关闭:随机对照试验的元分析与试验顺序分析的随机对照试验
P Marcolin1, S Mazzola Poli de Figueiredo2, B Oliveira Trindade3
1School of Medicine, Universidade Federal da Fronteira Sul, Passo Fundo, RS, Brazil. patricia.marcolin@estudante.uffs.edu.br.
Hernia : the journal of hernias and abdominal wall surgery
|January 22, 2024
概括
在紧急腹腔切除术关闭时,预防性网状增大减少了切口和形脱落. 虽然增加了手术时间和血清瘤风险,但网状网络的使用似乎是安全的,值得考虑.
科学领域:
- 手术创新 在外科创新.
- 胃肠道手术 胃肠道手术
- 腹壁的重建 腹壁的重建
背景情况:
- 预防性网用于紧急腹腔切除关闭仍然是争论的主题.
- 这项研究通过分析现有的随机对照试验来解决这一争议.
研究的目的:
- 进行随机对照试验 (RCT) 的元分析.
- 评估在紧急腹腔切除术关闭期间预防性网状放置的疗效和安全性.
主要方法:
- 对Cochrane,Scopus和PubMed数据库进行系统审查.
- 包括4个RCT和464名患者,不包括观察性研究和选择性程序.
- 使用RevMan 5.4进行聚合分析和元分析,以I2统计数据评估异质性,并使用RoB 2工具评估偏差风险.
主要成果:
- 网格增强显著降低了切口发生率 (OR 0.18) 和形脱 (OR 0.07).
- 在使用网格时观察到增加的操作时间 (MD 32.09分钟) 和血清瘤形成 (OR 3.89).
- 两组之间没有发现手术部位感染或重新手术的显著差异.
结论:
- 在紧急腹腔切除术关闭时,预防性网状增大与减少切口和形脱落有关.
- 尽管血清瘤的风险增加,但网格增大被认为是安全的,可以考虑.
- 建议进行进一步的研究,以评估在这种环境中使用网状网的长期结果.
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