laparoscopic与开放环节静脉切除术逆转:一个系统的审查和元分析
Tyler McKechnie1, Léa Tessier2, Tharani Anpalagan2
1Division of General Surgery, Department of Surgery, McMaster University, Hamilton, ON, Canada.
Surgery in practice and science
|January 23, 2025
概括
与开放式手术相比,腹腔镜环静脉切除术 (LI) 的逆转可能会减少住院时间和表面手术部位感染. 这种方法似乎是可行的,并且不会增加操作时间,尽管证据质量很低.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 最少侵入性的手术
- 手术结果研究研究.
背景情况:
- 循环结节切除术 (LI) 用于暂时的便转移,以保护下游结肠直肠瘤.
- 传统的LI逆转方法涉及开放式手术技术.
- 已经出现了用于LI逆转的腹腔镜技术,并且越来越多地研究.
研究的目的:
- 系统地审查和比较腹腔镜与开放循环静脉切除术逆转的结果.
- 为了评估手术后的发病率和两个手术方法之间的停留时间.
主要方法:
- 在Medline,Embase和CENTRAL数据库中进行了系统的文献搜索.
- 包括的研究比较了腹腔镜和开放LI逆转,重点关注术后发病率和停留时间 (LOS).
- 为了评估证据质量,采用了双对元分析和GRADE评估.
主要成果:
- 分析了四项涉及213个腹腔镜和176个开放LI逆转的观察性研究.
- 腹腔镜逆转与显著较短的LOS相关 (MD -0.39,p=0.03).
- 腹腔镜组的表面手术部位感染 (sSSI) 率较低 (OR 0.22,p=0.01),整体发病率相似.
结论:
- 低质量的证据表明,腹腔镜LI逆转是可行的,有可能减少LOS和sSSI而不增加手术时间.
- 需要进一步进行高质量的前性研究来验证这些发现.
- 腹腔镜LI逆转为开放技术提供了一个有前途的替代方案.
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