在内泌尿外科手术中检测残留结石的术内计算机断层扫描:系统性审查和元分析
Henrique L Lepine1, Fabio C Vicentini2, Eduardo Mazzucchi2
1Faculdade de Medicina da Universidade de São Paulo, São Paulo, SP, Brasil.
概括
在手术中CT扫描显著提高了皮肤透神经切除术 (PCNL) 程序的成功率,与传统方法相比,减少了重复干预和辐射暴露. 这提高了患者在内分泌学方面的结果.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 内分泌病学 在内分泌病学.
- 医疗成像医学成像
背景情况:
- 像PCNL和URS这样的内泌尿外科手术往往具有低于最佳的成功率,导致重新干预和辐射暴露的增加.
- 目前正在探索手术内计算机断层扫描 (ICT) 扫描作为一种改善这些手术结果的方法.
研究的目的:
- 系统地审查和对比手术内CT扫描与常规光镜指导在内分泌学中的研究进行元分析.
- 评估ICT对手术成功率,并发症,再干预率和辐射暴露的影响.
主要方法:
- 根据PRISMA指南进行系统审查和元分析,搜索数据库直到2023年12月.
- 直接比较ICT指导与非ICT指导的程序,重点是成功率,并发症和重新干预.
- 数据采用随机效应模型进行聚合,呈现为具有95%信心区间的几率比率.
主要成果:
- 对3个队列 (327名患者) 的分析显示,ICT的成功率 (84.5%) 与非ICT (41.4%) 相比显著更高.
- 与对照组 (32.6%) 相比,ICT组的再干预率较低 (12.6%).
- 在两项研究中,并发症率没有显著差异,而辐射暴露在两项研究中显著减少.
结论:
- 术内CT扫描显示PCNL手术的良好结果,与标准光镜相比,显著增加了无结石率.
- 信息和通信技术的使用显示出减少残留石头和相关后果的潜力,如重新干预和后续辐射暴露.
- 尽管研究有限,但ICT对内分泌病患者来说是一个有前途的进步.
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