腹腔镜转换为开放性尾切除术的术前风险因素:系统性审查和元分析
Arian Mirdamadi1, Mona Javid1, Ehsan Amini-Salehi1
1Gastrointestinal and Liver Diseases Research Center, Guilan University of Medical Sciences, Rasht, Iran.
International journal of surgery (London, England)
|May 27, 2025
概括
laparoscopic尾切除术 (LA) 转换为开放尾切除术 (OA) 预测的是年龄较大,男性性别,并发症和特定的临床发现. 识别这些危险因素有助于外科医生在急性尾炎 (AA) 的术后规划中.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 临床流行病学 临床流行病学
背景情况:
- 腹腔镜尾切除术 (LA) 是急性尾炎 (AA) 的标准,但发生转换为开放尾切除术 (OA).
- 确定LA转化为OA的手术前风险因素对于手术规划至关重要.
研究的目的:
- 系统地审查和元分析与从LA转换为OA相关的术前风险因素.
主要方法:
- 在PubMed,Web of Science,Scopus和Embase数据库中进行了搜索.
- 包括45项研究 (3,202,336名患者) 评估临床,实验室和成像风险因素.
- 使用固定或随机效应模型计算聚合赔率比率和平均值的标准差异.
主要成果:
- 从LA转换为OA的整体转换率为8.7%.
- 转换的重要预测因素包括年龄较大,男性性别,肥胖,糖尿病,高血压,心血管疾病,先前的腹部手术,长期症状,更高的阿尔瓦拉多得分,炎症标志物升高,以及成像发现,如更大的尾直径和腹腔内液.
结论:
- 老年,男性性别,并发症和特定的临床/成像发现是LA转化为OA的关键预测因素.
- 这些知识有助于外科医生在急性尾炎的外科手术期间风险分层.
- 局限性包括大多数研究的回顾性质和许多因素的中低质量证据.
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