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腹腔镜子宫切除术前机械性肠道准备:一项随机对照试验。

Mechanical bowel preparation before laparoscopic hysterectomy: a randomized controlled trial.

机构信息

University of North Carolina at Chapel Hill, Chapel Hill, North Carolina.

出版信息

Obstet Gynecol. 2014 Mar;123(3):562-567. doi: 10.1097/AOG.0000000000000121.

Abstract

OBJECTIVE

To examine the influence of mechanical bowel preparation on surgical field visualization during laparoscopic hysterectomy.

METHODS

The study's primary outcome was the percentage of operations rated "good" or "excellent" in terms of surgical field visualization at the outset of the case by the primary surgeon. Additional measures included assessment of visualization during the case and patient perioperative comfort. The study was powered to detect a 20% absolute difference in the proportion of cases rated as "good" or "excellent."

RESULTS

Seventy-three patients were assigned to mechanical bowel preparation and 73 to no mechanical bowel preparation. The groups were comparable regarding patient and surgery characteristics. No differences were found for this rating between groups (mechanical bowel preparation, 64 of 73 patients [87.7%], compared with no mechanical bowel preparation, 60 of 73 patients [82.2%], P=.36). Surgeons guessed patient assignment correctly 59% of the time (42 of 71 patients) with mechanical bowel preparation and 55% of the time (41 of 75 patients) with no mechanical bowel preparation.

CONCLUSION

Mechanical bowel preparation is well-tolerated but does not influence surgical field visualization for laparoscopic hysterectomy.

CLINICAL TRIAL REGISTRATION

ClinialTrials.gov, www.clinicaltrials.gov, NCT01576965.

摘要

目的

研究机械性肠道准备对腹腔镜子宫切除术手术视野可视化的影响。

方法

本研究的主要结局是由主要外科医生评估手术视野在手术开始时为“良好”或“优秀”的手术比例。其他测量指标包括对手术过程中的可视化评估以及患者围手术期舒适度。本研究的目的是检测手术视野评估为“良好”或“优秀”的病例比例绝对差异 20%。

结果

73 例患者接受机械性肠道准备,73 例患者未接受机械性肠道准备。两组患者的特征和手术情况相似。两组之间该评分无差异(机械性肠道准备组 73 例患者中有 64 例[87.7%],无机械性肠道准备组 73 例患者中有 60 例[82.2%],P=.36)。对于机械性肠道准备,外科医生正确猜测患者分组的概率为 59%(71 例患者中有 42 例),而对于无机械性肠道准备,外科医生正确猜测患者分组的概率为 55%(75 例患者中有 41 例)。

结论

机械性肠道准备耐受良好,但不会影响腹腔镜子宫切除术的手术视野可视化。

临床试验注册

ClinialTrials.gov,www.clinicaltrials.gov,NCT01576965。

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