单切割与三口腹腔镜尾切除术的元分析,比较手术时间和术后疼痛
Kyung-Goo Lee1,2, Min Ki Kim1, Jong Seob Park1
1Department of Surgery, Myongji Hospital, Hanyang University College of Medicine, Goyang, Korea.
International journal of surgery (London, England)
|September 22, 2025
概括
单切口腹腔镜尾切除术 (SILA) 是治疗急性尾炎的常规腹腔镜尾切除术 (CLA) 的可行替代方案. 虽然SILA可能有稍长的操作时间,但它提供了可比的疼痛管理和优越的美容结果.
科学领域:
- 最少侵入性的手术
- 手术结果研究研究.
- 胃肠道手术 胃肠道手术
背景情况:
- 关于急性尾炎的单切口腹腔镜尾切除术 (SILA) 和三端口常规腹腔镜尾切除术 (CLA) 之间的手术时间和术后疼痛存在持续的争论.
- 本研究通过对随机临床试验 (RCT) 的系统审查和元分析来解决这些临床问题.
研究的目的:
- 为了比较急性尾炎的SILA与CLA的临床结果.
- 为了评估手术时间,术后疼痛,并发症,转化率和美容满意度.
主要方法:
- 系统性审查和RCT的元分析,比较SILA和CLA.
- 通过PubMed,Embase和Cochrane中央注册的电子搜索到2025年1月.
- 超回归分析用于评估随时间推移手术结果的趋势.
主要成果:
- 总共包括了21个RCT,包括2454名患者. SILA显示了更长的手术时间的趋势 (MD = 3.80分钟,p = 0.07),但这种差异在最近的手术中减少了 (p = 0.003).
- 在12或24小时的疼痛得分中没有观察到显著的差异. 需要使用的CLA止痛药较少 (SMD=0.24,p<0.01).
- 术后并发症和开放转换率相似. SILA表现出更高的化品满意度,尽管在7%的SILA病例中需要额外的托卡.
结论:
- SILA是急性尾炎治疗的可行替代方案,特别是对于优先考虑化品效果的患者.
- 减少的手术时间差异和可管理的疼痛支持SILA的考虑.
- 建议仔细选择患者,以获得SILA的最佳结果.
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