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科克大陆静脉切除术后的并发症和失败:系统性审查和元分析
S H Emile1,2, Z Garoufalia1, S Mavrantonis3
1Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, 2950 Cleveland Clinic Blvd, Weston, FL, 33331, USA.
Techniques in coloproctology
|October 1, 2024
概括
科克囊 (KP) 具有很高的并发症率 (60%),通常需要修改. 增加的BMI和先前的囊解剖 (IPAA) 是并发症的危险因素,但不是囊衰竭.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
背景情况:
- 科克袋 (KP) 是用于尿路转移或便管理的手术选择.
- 有相当数量的患者经历了KP并发症,需要修订或切除.
研究的目的:
- 系统地审查和评估Kock袋的并发症和失败率的综合流行率.
- 为了确定与科克袋并发症和失败相关的风险因素.
主要方法:
- 一个符合PRISMA的系统审查和对2000年以后发表的研究的元分析.
- 在PubMed,Scopus和Web of Science中搜索了科克大陆结节术的成年患者的研究.
- 使用ROBINS-1评估偏差风险并进行比例元分析和元回归.
主要成果:
- 包括19项涉及2042名患者的研究;综合并发症患病率为60.4%,修订患病率为46.6%,失败患病率为12.9%.
- 增加的体重指数 (BMI) 和先前的囊解剖 (IPAA) 与更高的并发症率有关.
- 这些风险因素 (BMI,以前的IPAA) 并没有显著地与囊失效的增加有关.
结论:
- 科克囊是一种复杂的手术,并发症率很高,最好由经验丰富的外科医生进行.
- 尽管并发症和修订率很高,但患者往往希望保留他们的科克包.
- 虽然BMI和之前的IPAA增加了并发症风险,但它们并不能预测科克袋的失败.
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