穿孔周周炎中腹腔镜治疗的可行性和结果:一项前性队列研究,与倾向性得分匹配
Shruti Soni1, Yash Kumar Parihar1, Ramkaran Chaudhary1
1Department of General Surgery, All India Institute of Medical Sciences, Jodhpur, Rajasthan, India.
穿孔外周炎的腹腔镜手术是可行的,与开放腹腔切除术相比,减少了住院时间和疼痛. 虽然手术时间较长,但它在紧急手术中提供了可行的替代方案.
科学领域:
- 紧急手术 紧急手术
- 最少侵入性的技术
- 外科手术的结果
背景情况:
- 穿孔周周炎在紧急手术患者中具有显著的发病和死亡风险.
- 开放性腹腔切除术是传统的方法,但微创性腹腔镜手术正在作为一种替代方案出现.
- 这项研究评估了腹腔镜治疗的可行性和有效性,而不是穿孔周周炎的开放腹腔切除术.
研究的目的:
- 为了比较腹腔镜手术和穿孔周周炎患者的开放腹腔切除术的结果.
- 评估在紧急手术环境中最少侵入性方法的可行性和有效性.
- 分析两个手术方法之间的手术时间,术后停留,疼痛,发病率和死亡率.
主要方法:
- 一项前性观察性研究包括140名穿孔腹膜炎患者 (2022年1月 - 2023年5月).
- 110名患者接受了腹腔切除术,30名患者接受了腹腔镜治疗.
- 倾向性得分匹配 (1:1) 创建了两组,每组为28名患者进行比较.
主要成果:
- 腹腔镜手术的手术时间较长 (217.43分钟对182.46分钟;P=0.049).
- 腹腔镜组的住院时间显著缩短 (4.39天与8.68天相比;P<0.001) 和术后疼痛较低.
- 腹腔镜组的30天发病率降低了 (10%对32%),手术部位感染和重复手术的数量更少.
结论:
- laparoscopic 手术 是一个可行的和有效的选择,为选定的穿孔周周炎病例.
- 益处包括减少手术后疼痛和更短的住院时间.
- 增强的外科专业知识和患者选择可以优化腹腔镜在紧急手术中的作用.
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