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开放式和机器人前前腹修复的结果:一个倾向匹配的分析
Samantha W Kerr1, William R Lorenz1, Alexis M Holland1
1Division of Gastrointestinal and Minimally Invasive Surgery, Department of Surgery, Carolinas Medical Center, Charlotte, NC, USA.
概括
机器人腹修复 (RVHR) 和开放腹修复 (OVHR) 在并发症,重新手术和复发方面表现相似. 与OVHR相比,RVHR提供了更短的住院时间,但成本更高.
科学领域:
- 微创手术是最少的侵入性手术.
- 腹壁的重建 腹壁的重建
- Hernia 修复 Hernia 修复 的方法
背景情况:
- 最少侵入性腹壁重建,包括机器人腹修复 (RVHR),越来越多地用于复杂的病例.
- 虽然RVHR提供了潜在的好处,如减少停留时间和伤口并发症,但它的使用仍在争论中.
- 开放腹腔修复 (OVHR) 是一种传统的腹壁重建方法.
研究的目的:
- 为了比较前腹开放 (OVHR) 和机器人腹修复 (RVHR) 之间的结果,成本和手术时间.
- 在复杂的患者群体中评估RVHR与OVHR的疗效和经济影响.
主要方法:
- 从2016年到2023年,在第三级中心对1112个OVHR和94个RVHR病例进行了前性审查.
- 对91对进行了倾向匹配分析,以控制影响结果的混因素.
- 关键的患者人口统计,手术细节和术后结果在匹配组之间进行了比较.
主要成果:
- 匹配组 (91对) 在BMI,伤口类别,ASA得分,缺陷大小,糖尿病,吸烟状况或初级与复发性修复方面没有显著差异.
- 在OVHR和RVHR之间,手术时间和伤口并发症率相似 (p > 0.05).
- RVHR使用较小的网格 (p < 0.001),导致停留时间较短 (p < 0.001),但运营和总费用较高 (p < 0.001).
- 两种方法之间没有观察到重新手术或的复发率的统计差异 (p > 0.05).
结论:
- 腹膜前OVHR和RVHR在伤口并发症,重复手术,手术时间和的复发方面表现出相似的疗效.
- 与OVHR相比,RVHR与较短的逗留时间有关.
- 尽管住院时间较短,但RVHR导致整体医疗费用显著上升.
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