在腹腔修复中,复发率和网状凸减少:PROSECO随机临床试验
Mikael Lindmark1,2, Jael Tall3,4, Bahman Darkahi5
1Department of Diagnostic and Intervention, Umeå University, Umeå, Sweden.
The British journal of surgery
|September 2, 2025
概括
在腹腔镜内皮层上修复中线时,主要的关闭显著减少了复发和凸. 这种技术也减少了术后的疼痛,建议与标准的网状修复一起使用.
科学领域:
- 外科创新
- 的修复技术
- 最少侵入性的手术
背景情况:
- 在中线中进行腹腔镜内膜网 (IPOM) 修复可能会导致高的并发症.
- 在将网格放置之前进行主要关闭是一种潜在的减轻这些并发症的技术.
- 进行了一项多中心试验,以评估初级关闭在减少部位并发症方面的有效性.
研究的目的:
- 与腹腔镜IPOM修复中的桥梁技术相比,研究主要关闭是否能减少部位的并发症.
- 评估一次性关闭对复发,网状凸和术后疼痛的影响.
- 为了比较两种手术方法之间的临床和CT评估并发症率.
主要方法:
- 一个随机,并行,双盲,多中心的受控试验,涉及中线的成年人.
- 在放置网格之前,患者被随机分配到主要的关或桥梁技术中.
- 在手术前和手术后12个月进行了临床评估,腹腔痛问卷和CT扫描.
主要成果:
- 在12个月内,关闭 (18%) 和桥梁 (20%) 之间的整体部并发症率没有显著差异.
- 关闭组的复发率显著降低 (4%对20%) 和网状凸 (P=0.006).
- 经过关闭的患者在12个月的随访中报告疼痛明显减少.
结论:
- 虽然整体并发症率的初级终点没有达到,但初级关闭显著减少了的复发和网状凸.
- 在腹腔镜IPOM修复中,主关闭与手术后疼痛的减少有关.
- 这些发现支持建议用于IPOM修复中线的初级关闭.
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