腹膜排水与没有排水在复杂尾炎的腹腔镜尾切除术后的优点比较:一个元分析
Hongsheng Wu1, Biling Liao2, Tiansheng Cao2
1Department of Hepatobiliary Pancreatic Surgery, Huadu District People's Hospital of Guangzhou, Guangzhou, 510800, Guangdong, PR China. crazywu2007@126.com.
BMC gastroenterology
|November 16, 2024
概括
在腹腔镜尾切除术 (LA) 后,对于复杂的尾炎,不建议进行常规腹腔管疏通 (PD). 这项元分析发现,PD增加了伤口感染和疼痛,同时延长了手术和住院时间.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
- 基于证据的医学基于证据的医学.
背景情况:
- 腹腔疏通 (PD) 已成为复杂尾炎的腹腔镜尾切除术 (LA) 后的传统做法.
- 最近的证据质疑PD的益处,表明它可能会增加并发症和医疗费用.
- 进行了一项元分析,以解决围绕复杂尾炎中PD必要性的争议.
研究的目的:
- 为了评估腹膜疏通的有效性和安全性,而不是在复杂尾炎的腹腔镜尾切除术后没有疏通.
- 评估PD对术后并发症,疼痛,手术时间和住院时间的影响.
主要方法:
- 在PubMed,Springer和Cochrane图书馆 (2000-2022) 进行了系统的文献搜索.
- 根据PRISMA标准,包括了12项涉及3374名患者的研究.
- 主要结局包括伤口感染和疼痛 (VAS得分);次要结局是手术时间和住院时间. 分析使用了固定或随机效应模型.
主要成果:
- 腹腔疏通 (PD) 与明显更高的伤口感染率和术后疼痛 (VAS评分) 相关.
- 此外,PD还导致了显著更长的手术时间,术后恢复时间和整体住院.
- 两组之间没有观察到腹内,肠道阻塞或漏的显著差异.
结论:
- 在腹腔镜尾切除术后,对于急性复杂尾炎,不建议进行常规腹腔管疏通.
- 皮肤病增加了伤口感染的风险,加剧了术后疼痛,并延长了康复和住院时间.
- 非排水似乎是一个安全和潜在的更有效的方法,为选定的患者.
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