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在腹腔镜胆固醇切除术期间金属与非吸收性聚合物片的影响
A J Bartholomew1, C Jing1, K P Economopoulos1
1Department of Surgery, Duke University School of Medicine, Durham, NC, USA.
Surgical endoscopy
|February 12, 2025
概括
聚合物片是腹腔镜胆囊切除术 (LC) 的安全替代品. 虽然最初的急诊室访问量更高,但调整后的分析显示没有与片类型的联系,这表明聚合物片是一种可行的选择.
科学领域:
- 手术创新 在外科创新.
- 医疗器械技术 医疗器械技术
- 胃肠道手术 胃肠道手术
背景情况:
- 在腹腔镜胆囊切除术 (LC) 期间,金属剪贴是囊性通道和动脉封闭的标准.
- 非可吸收的聚合物片提供了锁定替代方案,但对其在LC中的采用,安全性和成本的研究是有限的.
研究的目的:
- 在LC中评估聚合物片的采用,安全性和成本效益,与传统金属片相比.
- 分析剪贴类型对30天急诊室 (ED) 访问,再入院和并发症的影响.
主要方法:
- 从2017年到2019年,根据金属或聚合物剪贴的使用情况划分,对2017年至2019年的选择性LC案件进行了回顾性审查.
- 主要结果:30天ED访问率. 二次结果:再入院,并发症,外科医生利用率和成本分析.
- 统计分析包括千平方,威尔科克森等级和多变量逻辑回归.
主要成果:
- 在1244个LC中,75.1%使用金属片. 在聚合物组中,30天的急救访问量较高 (12.4%对7.2%,p=0.005),但调整后的分析将急救访问与医院设施和保险联系起来,而不是剪贴类型.
- 30天的再入院率是可比的 (4.9%的聚合物与3.2%的金属,p=0.18).
- 聚合物剪贴每例75美元便宜;喜欢聚合物剪贴的外科医生是最近的毕业生,更有可能进行手术内胆血管图.
结论:
- 聚合物片是LC中金属片的安全替代品,具有类似的并发症概况.
- 尽管ED访问率较高,但调整后的数据表明,聚合物片并没有独立地与术后ED访问量增加有关.
- 成本效益和安全概况支持在LC决策中考虑聚合物片.
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