在初级腹腔修复中,开放式和腹腔镜方法之间的比较:系统性审查和元分析
Márcia Regina Martins1, Hugo Santos-Sousa2,3, Miguel Alves do Vale1
1Faculty of Medicine, University of Porto, Porto, Portugal.
Langenbeck's archives of surgery
|February 2, 2024
概括
与开放式手术相比, laparoscopic 初级腹腔修复显示出较低的复发率和并发症率. 这种最少的侵入性方法可以提供更好的结果,尽管有一些研究的局限性.
科学领域:
- 腹部外科手术 腹部外科手术
- 最少侵入性手术是最少侵入性的手术.
- Hernia 修复 Hernia 修复 的方法
背景情况:
- 腹腔修复技术已经发展,腹腔镜作为开放手术的替代品出现.
- 腹腔镜初级腹腔修复避免了腹部大切口,可能改善患者的康复.
- 需要对临床结果进行系统的评估,比较腹腔镜和开放方法.
研究的目的:
- 系统地比较腹腔镜与初级腹腔的开放手术方法的临床结果.
主要方法:
- 在2023年2月,在主要数据库 (PubMed,Scopus,Web of Science,Cochrane) 进行了系统的文献搜索.
- 包括随机对照试验,比较了腹腔镜和开放的初级腹腔修复.
- 进行了对的复发,感染,伤口脱光,血清瘤,术后疼痛,手术持续时间,住院和恢复工作的元分析.
主要成果:
- 在分析中包括了9项研究.
- 腹腔镜修复与明显较低的病复发率 (RR=0.49),局部感染 (RR=0.30),伤口脱光 (RR=0.08) 和局部血清瘤 (RR=0.34) 相关.
- 对包括术后疼痛,手术持续时间,住院时间和返回工作时间在内的结果观察到显著的异质性.
结论:
- 尽管现有研究的局限性 (偏见,小样本大小),腹腔镜似乎优于初级腹腔.
- 腹腔镜方法表明的复发和手术部位并发症的频率降低.
- 需要进一步的研究和强大的协议来证实这些发现.
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