带有或没有子宫切除术的结肠切除. 一个系统的审查和元分析
Dimitrios Zacharakis1, Anastasia Prodromidou1, Nikolaos Kathopoulis1
11st Department of Obstetrics and Gynaecology, National and Kapodistrian University of Athens, "Alexandra" General Hospital, Athens, Greece.
概括
将子宫切除术添加到骨盆器官脱落 (POP) 的手术中,增加了手术时间和血液损失. 然而,它并没有显著影响并发症率或住院时间,这表明对个体患者要仔细考虑.
科学领域:
- 妇科 妇科 妇科 妇科
- 外科手术的结果
- 盆地底疾病 盆地底疾病
背景情况:
- 骨盆器官脱落 (POP) 是女性普遍存在的疾病,经常需要手术治疗.
- 科尔波克莱西斯是一种成熟的消灭性手术,特别是在患有晚期POP的脆弱女性身上.
- 结合科尔波克莱西斯和子宫切除术的必要性是正在进行的临床辩论的主题.
研究的目的:
- 为了比较与并发子宫切除术相对进行的结肠切除术的术后结果.
- 为了评估宫内切除术对手术持续时间,血液损失和手术后并发症的影响,在POP患者中进行结肠切除术.
主要方法:
- 一个系统的审查和元分析,遵循PRISMA指南.
- 搜索了包括PubMed,Scopus和Google Scholar在内的数据库,直到2025年1月.
- 包括对带有和不带有子宫切除术的输卵管结合症的比较研究,分析手术时间,血液损失,并发症,输血率和住院时间.
主要成果:
- 分析了四项追溯性研究,涉及1423名患者 (370名经过子宫切除,1043名没有).
- 子宫切除术与明显延长的手术时间 (MD: -27.79分钟; p=0.01) 和增加的血液损失 (MD: -17.78毫升; p=0.001) 相关.
- 在并发症率 (OR:0.95;p=0.83),输血率 (OR:0.77;p=0.65) 或住院 (MD: -0.16天;p=0.55) 中没有发现显著差异.
结论:
- 结合子宫切除的结肠切除延长了手术时间,增加了血液损失,但没有提高并发症率或住院时间.
- 虽然切除子宫术可以预防未来的子宫病理,但其额外的手术风险是最小的.
- 个性化,以患者为中心的决策是必要的,当考虑切除子宫的同时colpocleisis.
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