对双边 inguinal hernias 的患者进行开放式和拉帕罗内镜修复技术的比较
Divyansh Agarwal1, Tina Bharani2, Nora Fullington3,4
1Department of Surgery, Massachusetts General Hospital, 55 Fruit St., GRB 425, Boston, MA, 02114, USA. dagarwal@mgh.harvard.edu.
概括
对于初级双侧 inguinal hernia 修复,腹腔镜,机器人和开放网状修复,显示了可比的手术和患者报告的结果. 需要进一步的研究来澄清组合开放修复技术对结果的影响.
科学领域:
- 椎间板手术 手术 椎间板手术
- 手术结果研究研究.
- 最少侵入性的手术
背景情况:
- 国际指导方针建议对初级双侧 inguinal 进行腹腔镜后面网状修复,因为更好的疼痛概况和恢复.
- 对于双边 inguinal hernias 的 laparoscopic 和机器人方法的开放网状修复存在有限的比较研究.
- 腹部核心健康质量协作 (ACHQC) 注册表提供了分析这些修复方法的数据.
研究的目的:
- 为了比较手术和患者报告的结果,开放,腹腔镜和基于机器人网的双边 inguinal hernia 修复.
- 通过使用 ACHQC 注册表数据,评估不同外科手术方法的结果相似的假设.
主要方法:
- 利用来自ACHQC注册 (2012-2024) 的数据进行双边 inguinal hernia 修复.
- 采用了基于 3:1 倾向分数的匹配方法来比较开放,机器人和腹腔镜队列之间的结果.
- 评估患者报告的生活质量 (EuraHS分数),术后并发症和的复发率.
主要成果:
- 匹配分析包括575名 (拉巴罗镜),524名 (机器人) 和208名 (开放式) 个体;联合拉巴罗内镜与开放式分别包括627名和211名.
- 在3年随访期间,没有观察到统计学上显著或临床上有意义的EuraHS得分差异 (p=0.19).
- 两组之间在的复发,手术部位发生,出血,神经损伤,血栓栓塞事件或尿路感染方面没有发现显著差异.
结论:
- laparoscopic,机器人,和开放的方法展示了可比的外科手术和患者报告的结果,用于ACHQC注册的初级双边 inguinal hernia修复.
- 在"开放"队列中包含各种开放修复技术 (前后) 可能会影响结果,需要进一步调查.
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