在跨腹部和逆腹腔上腺切除术之间,相当的疼痛和阿片类药物使用
Lauren Haskins1, Nicole Tobin2, Elle Reineman2
1Department of Surgery, East Carolina University, Greenville, North Carolina.
The Journal of surgical research
|November 16, 2024
概括
腹腔镜穿越腹部上腺切除术 (LTA) 和后部上腺切除术 (PRA) 显示了类似的术后疼痛和阿片类药物使用. 患者因素,而不是手术方法,应该指导LTA和PRA之间的选择.
科学领域:
- 最少侵入性的手术
- 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:
- 腹腔镜穿越腹部上腺切除术 (LTA) 和后部上腺切除术 (PRA) 是已知,安全和有效的上腺切除手术技术.
- 对手术后疼痛和阿片类药物消费在LTA和PRA之间的直接比较分析对于优化手术决策至关重要.
研究的目的:
- 为了直接比较腹腔镜穿越腹腔大 adrenalectomy (LTA) 和后置逆皮透镜大 adrenalectomy (PRA) 之间的术后疼痛和阿片类药物利用.
- 评估手术方法对患者报告的疼痛,阿片类药物使用,停留时间和再入院率的影响.
主要方法:
- 在2015年至2021年期间在第三级护理中心进行了腹腔镜上腺切除术的成年患者的回顾性分析.
- 使用多变量线性回归分析了包括术后阿片类药物使用和患者报告的疼痛评分在内的关键结果,并比较了LTA和PRA方法.
- 收集的其他数据包括出院后的疼痛,处方补充,停留时间和30天再入院率.
主要成果:
- 该研究包括88次LTA和39次PRA手术,患者人群平均年龄为54岁,58%为女性,75%患有功能性上腺瘤.
- 在休息时的疼痛评分 (4.4 LTA vs. 4.5 PRA) 或活动期间 (4.7 LTA vs. 5.6 PRA) 没有观察到统计学上显著的差异.
- 中位数阿片类药物使用为LTA的110.3MME与PRA的91.0MME (P=0.16),多变量分析显示两种方法之间没有显著差异 (-9.3MME).
结论:
- 后背皮上腺切除术 (PRA) 在术后疼痛或阿片类药物消耗方面与腹腔镜横腹上腺切除术 (LTA) 相比没有显著的优势.
- 无论是LTA还是PRA,都显示出相似的临床结果,这表明选择手术方法应根据患者特定因素进行个性化选择.
- 这些发现与一些先前的研究形成了鲜明对比,强调了在上腺切除术手术规划中需要仔细考虑患者特征的必要性.
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