腹腔镜切除术与尾切除术后的并发症:国家分析
Yael Yagur1, David Rosen2, Gabriel Levin3
1Department of Obstetrics and Gynecology, Meir Medical Center, Kfar Saba, Israel; School of medicine, Faculty of Medical and Health Sciences, Tel Aviv University, Tel Aviv, Israel.
Journal of minimally invasive gynecology
|September 2, 2025
概括
在腹腔镜切除术 (LH) 中增加尾切除会增加主要并发症和手术时间. 虽然整体风险较低,但患者个体因素应指导同时进行尾切除的决定.
科学领域:
- 妇科手术
- 手术的结果
- 患者安全
背景情况:
- 腹腔镜切除子宫 (LH) 是一种常见的治疗良性妇科疾病的手术.
- 在LH期间同时进行尾切除的作用受到争议.
- 了解相关风险对于手术决策至关重要.
研究的目的:
- 评估LH期间同时进行尾切除与短期术后并发症之间的关联.
- 为了比较单独的LH和尾切除的LH之间的并发症率,手术时间和住院时间.
主要方法:
- 使用美国外科医生学院国家外科质量改进计划 (NSQIP) 数据库前性收集的队列研究.
- 包括因良性妇科症状接受LH治疗的妇女 (2012-2022年).
- 使用倾向性得分匹配 (1: 3) 来比较单独的LH和同时进行尾切除的LH的结果.
主要成果:
- 同时的尾切除与整体 (7. 8% 与 6. 2%) 和重大术后并发症 (3. 7% 与 2. 3%) 的更高率有关.
- 尾切除术也增加了手术时间 (152.2分 vs 135.3分) 和住院时间 (1.2天 vs 0.8天).
- 多变量分析证实尾切除与任何并发症,重大并发症和更长的住院时间的增加有关.
结论:
- 在LH期间同时进行尾切除与严重的术后并发症,手术时间和住院时间的增加有关.
- 整体增加的风险很低,强调需要个性化手术决定.
- 诸如手术复杂性,手术内发现和患者特异性风险等因素应指导尾切除的决定.
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