对非复杂急性尾炎进行内镜逆行性尾炎治疗的可行性和有效性:系统性审查和元分析
Zhu Li1, Yongquan Chen1, Xiaobin Zhang1
1Department of Gastrointestinal Surgery, The Sixth Affiliated Hospital, School of Medicine, South China University of Technology, Foshan, 528000, People's Republic of China.
内镜逆行性尾炎治疗 (ERAT) 显示出对无并发性尾炎的承诺,比抗生素更少的不良反应. 然而,其较低的成功率和较高的复发率意味着它还不能取代尾切除术.
科学领域:
- 胃肠病学 胃肠病学
- 手术创新 在外科创新.
- 最少侵入性手术的方法
背景情况:
- 急性尾炎是一种常见的手术紧急情况.
- 尾切除和抗生素是标准的治疗方法.
- 内镜逆行性尾炎治疗 (ERAT) 是一个新兴的微创性选择.
研究的目的:
- 评估ERAT对无并发性急性尾炎的可行性和有效性.
- 将ERAT结果与传统治疗方法进行比较.
主要方法:
- 对PubMed,Embase,Web of Science和Cochrane图书馆数据库进行系统的文献审查.
- 使用Review Manager 5.4与随机效应模型进行元分析.
- 包括8项研究 (3项RCT,5项追溯) 与2005年参与者.
主要成果:
- 与腹腔镜尾切除术 (LA) 相比,ERAT的成功率较低,复发率更高.
- ERAT显示了比抗生素更高的成功率和更低的复发率的趋势,但不具有统计学意义.
- 与抗生素治疗相比,ERAT导致的不良事件显著减少.
结论:
- ERAT是治疗无并发性尾炎的有希望的替代方案,具有器官保存的好处和比抗生素少的不良反应.
- 目前的ERAT成功率和复发率限制了其取代尾切除术的能力.
- 需要进一步进行高质量的研究,以确定ERAT的最终临床作用.
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