全喉切除术后吻合器咽关闭术的疗效：一项系统评价
Efficacy of stapler pharyngeal closure after total laryngectomy: A systematic review.
作者信息
Aires Felipe T, Dedivitis Rogério A, Castro Mario Augusto F, Bernardo Wanderley Marques, Cernea Claudio Roberto, Brandão Lenine Garcia
机构信息
Centro Universitário Lusíada, Santos, Brazil.
出版信息
Head Neck. 2014 May;36(5):739-42. doi: 10.1002/hed.23326. Epub 2013 Jun 1.
BACKGROUND
Some primary studies compare manual and mechanical pharyngeal closures after total laryngectomy. The purpose of this study was to evaluate the advantages of the mechanical suture in pharyngeal closure.
METHODS
The literature survey included research in MEDLINE, EMBASE, and LILACS. The intervention analyzed was stapler-assisted pharyngeal closure, whereas the control group was manual suture pharyngeal closure.
RESULTS
The survey resulted in 319 studies. However, 4 studies were selected (417 patients). In the group of patients in whom the stapler was used, the incidence of pharyngocutaneous fistula was 8.7%, whereas in the other, it was 22.9%, with an absolute risk reduction of 15% (95% confidence interval [CI], 0.02-0.28; p = .02; I(2) = 66%). Regarding the surgical time, the average difference was 80 minutes in favor of the stapler group (95% CI, 23.16-136.58 minutes; p < .006).
CONCLUSION
The difference for starting oral feeding was 8 days in favor of the mechanical suture (95% CI, 4.01-11.73 days; p < .001). Patients who underwent mechanical suture had a shorter hospitalization period.
背景
一些初步研究比较了全喉切除术后手动和机械咽闭合术。本研究的目的是评估机械缝合在咽闭合术中的优势。
方法
文献检索包括MEDLINE、EMBASE和LILACS中的研究。分析的干预措施是吻合器辅助咽闭合术，而对照组是手动缝合咽闭合术。
结果
检索得到319项研究。然而，选取了4项研究（417例患者）。使用吻合器的患者组咽皮肤瘘的发生率为8.7%，而另一组为22.9%，绝对风险降低15%（95%置信区间[CI]，0.02 - 0.28；p = 0.02；I² = 66%）。关于手术时间，平均差异为有利于吻合器组80分钟（95% CI，23.16 - 136.58分钟；p < 0.006）。
结论
开始经口进食的差异有利于机械缝合8天（95% CI，4.01 - 11.73天；p < 0.001）。接受机械缝合的患者住院时间较短。
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