复杂分泌炎的外科治疗:系统审查和个体患者数据网络的元分析:一个EAES/ESCP合作项目
Bright Huo1, Monica Ortenzi2, Roi Anteby3,4
1Division of General Surgery, Department of Surgery, McMaster University, Hamilton, Canada. brighthuo@dal.ca.
Surgical endoscopy
|December 29, 2024
概括
对于欣奇分泌体炎,初级切除和解剖切除 (PRA) 可能会降低口率与哈特曼切除 (HR) 相比. 与HR和PRA相比, laparoscopic腹膜清洗 (LPL) 与死亡率的增加有关.
科学领域:
- 结肠直肠外科手术是什么意思
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
背景情况:
- 皮炎治疗指南需要更新证据.
- 个性化患者数据 (IPD) 网络元分析 (NMA) 可以为临床实践提供信息.
- 对比哈特曼切除 (HR),初级切除和解肠切除 (PRA) 和腹腔镜腹膜洗 (LPL) 对于亨奇膜炎至关重要.
研究的目的:
- 进行系统审查和IPD NMA.
- 为了比较HR,PRA和LPL的Hinchey分泌体炎 (Ib-IV类).
- 为基于证据的临床实践建议提供信息.
主要方法:
- 在MEDLINE,Embase和Cochrane中央系统搜索 (2023年10月).
- 包括随机对照试验 (RCT),比较HR,PRA或LPL.
- IPD的随机效应NMA,使用GRADE和CINeMA评估的证据确定性.
主要成果:
- 分析了7个RCT (595/678名患者) 的数据.
- laparoscopic腹膜洗 (LPL) 显示了较高的住院/30天死亡率与HR和PRA (低确定性) 相比.
- 初级切除和解肠切除 (PRA) 表明,与LPL (低确定性) 相比,静脉口腔的发生率较低.
结论:
- 与HR相比,PRA可能会降低1年的口腔狭窄率.
- 在PRA和HR之间30天/住院死亡率没有显著差异.
- 与HR和PRA相比,LPL与增加的住院/30天死亡率有关.
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