关于性结肠炎的IPAA中的争议:对不同解剖手术技术的系统审查
Paulo Gustavo Kotze1, Nicolas Avellaneda2, Rafaela de Araujo Molteni Moretti1
1Colorectal Surgery Unit, Pontificia Universidade Católica do Paraná (PUCPR), Curitiba, Brazil.
Diseases of the colon and rectum
|May 6, 2024
概括
本综述比较了手工,单和双的囊-门 (IPAA) 对性结肠炎. 由于简单性和良好的结果,双级IPAA被广泛采用,而单级IPAA显示了可比的结果.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 结肠直肠手术 结肠直肠手术
背景情况:
- 性结肠炎的治疗往往涉及修复性直肠切除术与阴囊-门解剖 (IPAA).
- 关键的IPAA技术包括手工,单和双解,每个都有不同的指示和结果.
- 对于性结肠炎患者的最佳IPAA技术存在争议.
研究的目的:
- 系统地审查和比较手工,单和双IPAA的技术方面,指示和术后结果.
- 提供基于证据的洞察力,了解IPAA在性结肠炎的恢复性直肠切除术中选择的技术.
主要方法:
- 使用PubMed进行了系统的文献审查,遵循PRISMA指南.
- 包括的研究重点关注了三种IPAA技术在接受性结肠炎恢复性直肠切除术的患者的结果.
- 评估的结果包括静脉漏,整体并发症率和囊功能.
主要成果:
- 该审查分析了21项初步研究和37项补充研究,从双阶段到单阶段技术的时间转变,特别是通过门的方法.
- 在1990-2015年期间,双式IPAA流行,通常与手工技术相比较.
- 2015年后的文献越来越多地采用单级IPAA,通常在跨门生殖切除设置中,与双级方法进行比较.
结论:
- 局限性包括手工IPAA研究的研究数量很少,以及作者自行决定添加的研究.
- 手工的IPAA可能适用于特定情况下,如因发育不良/癌症而进行粘膜切除术或重复手术.
- 双层IPAA因其简单性,门过渡区的保存,较低的并发症和充足的袋子功能而受到青;单层IPAA提供了具有可行和合理结果的自然设计.
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