单边双门内镜中的并发症及其预防:通过叙事见解和实际管理算法进行系统审查
Xavier A Santander1,2, Martin N Stienen3,4, Stefan Motov3,4
1Instituto Clavel, Madrid, Spain. xavier.santander@institutoclavel.com.
单侧双门内镜 (UBE) 用于脊柱减压是安全的,当技术是标准化的. 本综述综合了UBE并发症数据,并提出了管理算法,以改善患者的治疗结果.
科学领域:
- 神经外科 神经外科
- 最少侵入性的脊柱手术
背景情况:
- 单侧双门内镜 (UBE) 是一种新兴的微创技术,用于脊柱减压.
- 对UBE的并发症率和管理策略尚未得到充分确立.
研究的目的:
- 审查与UBE相关的并发症的发生率,预防和管理.
- 开发用于管理UBE相关并发症的实用算法.
主要方法:
- 在主要数据库中进行了系统的文献搜索 (2020-2025年).
- 包括专注于UBE脊柱手术的研究,包括至少50名患者和现有的并发症数据.
- 对发病率的数据进行了汇总;对二级文献进行了定性分析.
主要成果:
- 腰部UBE的综合发病率包括:2.4%的持续撕裂,~2%的外周血瘤/复发,2.5%的不完全减压,0.09%的手术部位感染和1.4%的重新手术.
- 在最初的学习曲线中,并发症率更高.
- 针对关键并发症开发了管理算法.
结论:
- 腰部UBE减压是安全的,可以通过经验丰富的外科医生使用标准化技术进行复制.
- 目前的证据基础受到研究设计和异质性的限制.
- 拟议的算法需要在多中心研究中进行前性验证.
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