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使用含药海绵增强组织密封的手术治疗的患者入选标准:观察性研究ELITE。

Patient eligibility criteria for a surgical treatment that enhances tissue sealing by use of a medicated sponge: observational study ELITE.

作者信息

Raiffort Cyril, Benabdallah Farid, Paillasseur Jean-Louis, Gangner Yves, Leutenegger Eric, Sockeel Philippe

机构信息

General and Gynaecologic Surgery, University Hospital of Lariboisière, 2 rue Amboise Paré, 75475 Paris, Cedex 10, France.

出版信息

Springerplus. 2013 Nov 18;2:613. doi: 10.1186/2193-1801-2-613. eCollection 2013.

Abstract

RATIONALE

The application of a haemostatic agent in general surgery, in addition to its effect on bleeding, also provides tissue sealing and adhesion. A sponge drug is used with some actions of resection and wide dissection, without knowledge of the eligibility of patients. In this study, we sought to identify clusters of patients for which the medicated sponge enhances tissue sealing.

METHODS

Observational study (ELITE), from a panel of selected surgeons from hospitals in France in several surgical areas: abdominal, gynaecology, urology and thoracic. The survey identified the criteria for using the sponge TachoSil® in their surgical practices involving n = 683 patients. A multiple correspondence analysis (MCA) followed by an ascending hierarchical classification (AHC) was used in order to identify the eligibility criteria for the application of the sponge for tissue sealing in addition to hemostasis.

RESULTS

The most relevant classification was based on 9 groups of patients for which the sponge was used. 6 of them are mainly linked with the kind of lesion, 2 with the site of application and the latest one with the type of operation.

CONCLUSIONS

The ELITE study revealed that the TachoSil® sponge was used mainly during surgery, requiring a reinforcement of the resection tissue sealing. The expected objective was successfully reached in 97% of the cases.

摘要

原理

在普通外科手术中,止血剂的应用除了对出血有作用外,还能实现组织封闭和粘连。一种海绵状药物在进行一些切除和广泛解剖操作时使用,但未考虑患者的适用性。在本研究中,我们试图确定使用含药海绵可增强组织封闭效果的患者群体。

方法

(精英研究),来自法国多家医院不同外科领域(腹部、妇科、泌尿科和胸科)的一组选定外科医生参与。该调查确定了他们在涉及n = 683例患者的手术操作中使用速即纱®海绵的标准。采用多重对应分析(MCA),随后进行升序层次分类(AHC),以确定除止血外使用该海绵进行组织封闭的适用标准。

结果

最相关的分类基于使用该海绵的9组患者。其中6组主要与病变类型有关,2组与应用部位有关,最后一组与手术类型有关。

结论

精英研究表明,速即纱®海绵主要在手术期间使用,此时需要加强切除组织的封闭。在97%的病例中成功实现了预期目标。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4ec1/3847034/95986e9e1d40/40064_2013_668_Fig1_HTML.jpg

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