结肠直肠和急诊外科患者在支持EHS和AHS关于腹部伤口关闭指南的文献中:颗粒状分析
Vittoria Bellato1, Sue Blackwell2, Muhammed Elhadi3
1Department of Minimally Invasive Surgery, University Hospital of Rome Tor Vergata, Rome, Italy.
Hernia : the journal of hernias and abdominal wall surgery
|October 22, 2025
概括
这项研究批判性地评估了结直肠和急诊手术患者的指南的证据. 调查结果显示,研究质量和数据存在重大局限性,需要针对性研究,以改善腹壁关闭建议.
科学领域:
- 手术 手术 手术 术 术
- 胃肠病学 胃肠病学
- Hernia 修复 椎间板裂的修复
背景情况:
- 欧洲和美国 Hernia Society (EHS/AHS) 的指导方针提供了关于腹壁关闭的建议.
- 在结直肠和急诊外科手术中评估这些指南的证据基础对于临床实践至关重要.
- 现有证据的质量和代表性需要进行批判性评估.
研究的目的:
- 批判性地评估支持EHS/AHS指南关于腹壁关闭的证据.
- 专注于结直肠和急诊手术患者的数据质量和数据表示.
- 为了确定腹壁关闭的研究中的差距.
主要方法:
- 对研究进行细分分析,解决关键问题 (KQ) 和EHS/AHS指南中的建议.
- 纳入标准侧重于报告结直肠或急诊手术的研究.
- 数据提取,质量评估和偏差风险评估都是独立进行的.
主要成果:
- 包括33项研究;许多系统性审查和随机对照试验具有低质量或高偏差风险.
- 具体建议的证据有所不同:KQ1 (切口类型) 和KQ3 (拉巴切口关闭) 对急诊患者的数据有限.
- 对于结直肠患者来说,KQ2的证据不足,因此不应将KQs1,2,6和7的建议推断为紧急患者.
- 在各个研究中报告了有限的以患者为中心的结果.
结论:
- 对于KQs 1,3,5,6和7的结直肠患者,EHS/AHS指南建议适用,但KQ2证据不足.
- 应仔细考虑紧急病人的建议,因为KQs1,2,6和7的证据并不直接适用.
- 对于这些手术群体来说,急需高质量,有针对性的研究,重点关注腹壁关闭的以患者为中心的结果.
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