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拉巴洛斯科比传统的开放先天双管阻塞修复:一个系统的审查和元分析

Mustafa Azizoglu¹, Tahsin Onat Kamci², Sergey Klyuev³

¹Istanbul Esenyurt Hospital, Department of Pediatric Surgery, Istanbul, Turkey; Istinye University Health Science Faculty, Department of Stem Cell and Tissue Engineering, Istanbul, Turkey; Pediatric Surgery Meta Analysis Group (PESMA), Istanbul, Turkey.

Journal of pediatric surgery

|October 2, 2024

概括

对于先天性十二指管阻塞 (CDO) 的腹腔镜手术 (LS) 提供了与开放手术 (OS) 相似的结果. 虽然OS的操作时间较短,但LS显示更快的食开始和更短的住院时间,减少了伤口感染率.

科学领域:

儿科手术儿科手术
最少侵入性的手术
胃肠道手术胃肠道手术

背景情况:

先天性十二指管阻塞 (CDO) 是新生儿需要手术干预的重要疾病.
腹腔镜手术 (LS) 和开放式手术 (OS) 是CDO的主要治疗方式.
评估LS与OS的比较安全性和有效性对于优化患者的治疗结果至关重要.

研究的目的:

系统地审查和分析LS的安全性和有效性,与新生儿CDO的OS相比.
为了比较关键的结果,包括手术持续时间,食进展,住院时间 (LOS) 和术后并发症.

主要方法:

一项系统的文献审查确定了与新生儿的LS和OS与CDO进行比较的研究.
进行了一项元分析,以综合有关手术持续时间,食开始,LOS和并发症的数据.
统计分析包括计算加权平均差异 (WMD) 和几率比率 (OR) 以95%置信区间 (CI).

主要成果:

包括11项涉及1615名新生儿的研究 (LS:338,OS:1277).
开放式手术 (OS) 显示了显著缩短的操作时间 (WMD 60.29 分钟).
腹腔镜手术 (LS) 显示了显著更快的食开始 (WMD -3.38天),更快的全食 (WMD -3.64天) 和更短的LOS (WMD -3.42天).
LS与伤口感染频率显著降低相关 (OR 0.26).
在LS和OS之间没有观察到异位膜泄漏,异位膜狭窄,术后阴茎或整体并发症的显著差异.

结论:

腹腔镜手术 (LS) 是对先天性十二指管阻塞 (CDO) 的开放手术 (OS) 的安全和有效替代方案.
在更快的恢复方面,LS提供了优势,包括更早的养和更短的住院时间.
虽然LS的手术时间可能更长,但整体术后并发症概况相似,伤口感染显著减少.

关键词:

生产时的十二指肠阻塞.laparoscopic 手术拉巴洛斯科普手术是用眼镜进行的手术.开放式手术是开放式手术.

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