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在结直肠ESD中预防性伤口关闭对术后伤口并发症的影响:元分析

Zhengdong Fang¹, Yan Xu², Xiaolin Huang²

¹Department of Critical Care Medicine, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, China.

International wound journal

|March 12, 2024

概括

预防性内镜闭合显著降低了大肠内镜下粘膜解剖 (ESD) 后的术后出血和发烧. 然而,它并没有显著降低穿孔率,这表明需要进一步研究高风险患者的识别.

科学领域:

胃肠病学胃肠病学
内視鏡外科手術內視鏡外科手術
在瘤学瘤学.

背景情况:

内镜下粘膜切割 (ESD) 对大肠瘤是有效的,但副作用的发生率很高.
预防措施的有效性,如伤口关闭,在预防结肠ESD后的并发症仍在争论中.

研究的目的:

评估预防性伤口关闭在预防大肠ESD后并发症的有效性.

主要方法:

来自PubMed,Embase和Cochrane图书馆的研究的元分析.
使用Q统计和I2测试评估异质性;用固定或随机效应模型分析数据.
在最初获取的1286篇论文中,选出了9篇符合条件的论文.

主要成果:

伤口关闭显著降低了手术后出血的风险 (OR,0.29;p < 0.0001).
伤口关闭和对照组之间的穿孔率没有显著差异 (OR,0.45;p = 0.06).
在伤口关闭组 (OR,0.37;p = 0.04) 观察到手术后发烧的显著降低.

结论:

预防性内镜关闭有效地降低了术后出血和发烧在结肠ESD的速度.
这种预防方法并没有显著降低术后穿孔的发生率.
未来的研究应该专注于识别高风险个体,以制定对结肠ESD并发症的成本有效预防策略.

关键词:

进行内镜下膜剖析.穿孔穿孔是指穿孔穿孔的情况.预防性关闭关闭伤口出血伤口出血

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