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儿童单孔与传统腹腔镜阑尾切除术:系统评价与荟萃分析

Single-incision versus conventional laparoscopic appendicectomy in children: a systematic review and meta-analysis.

作者信息

Zhao Lingling, Liao Zhenqi, Feng Shaoguang, Wu Peng, Chen Guorong

机构信息

Department of Pathology, The First Affiliated Hospital of Wenzhou Medical University, Wenzhou, China.

出版信息

Pediatr Surg Int. 2015 Apr;31(4):347-53. doi: 10.1007/s00383-015-3680-5. Epub 2015 Feb 10.

Abstract

PURPOSE

Single-incision laparoscopic appendectomy (SILA) has been considered as an alternative to conventional laparoscopic appendectomy (CLA). The aim of this systematic review and meta-analysis was to compare clinical outcomes between single-incision laparoscopic appendicectomy and conventional laparoscopic appendicectomy in children.

METHODS

An electronic search of EMBASE, PubMed, MEDLINE was performed. Operative time, length of hospital stay, postoperative complications including wound infection, intra-abdominal infection, ileus in SILA and CLA were pooled and compared by meta-analysis.

RESULTS

Twelve studies (4 randomized controlled trials, 1 prospective study and 7 retrospective studies) that included 2,109 pediatric patients were studied. Of these patients, 933 and 1,176 patients had undergone SILA and CLA, respectively. There was significant shorter length of hospital stay for SILA compared with CLA in children; however, pooling the results for SILA and CLA revealed no significant difference in operative time and postoperative complications.

CONCLUSION

Compared with CLA, SILA has the advantage of shorter hospital stay. However, SILA failed to show any obvious advantages over CLA in operative time and postoperative complications including wound infection, intra-abdominal infection, and ileus.

摘要

目的

单孔腹腔镜阑尾切除术(SILA)已被视为传统腹腔镜阑尾切除术(CLA)的一种替代方法。本系统评价和荟萃分析的目的是比较儿童单孔腹腔镜阑尾切除术与传统腹腔镜阑尾切除术的临床结局。

方法

对EMBASE、PubMed、MEDLINE进行电子检索。汇总并通过荟萃分析比较手术时间、住院时间、术后并发症(包括SILA和CLA中的伤口感染、腹腔内感染、肠梗阻)。

结果

共纳入12项研究(4项随机对照试验、1项前瞻性研究和7项回顾性研究),涉及2109例儿科患者。其中,分别有933例和1176例患者接受了SILA和CLA。与CLA相比,儿童SILA的住院时间显著缩短;然而,汇总SILA和CLA的结果显示,手术时间和术后并发症无显著差异。

结论

与CLA相比,SILA具有住院时间较短的优势。然而,SILA在手术时间和包括伤口感染、腹腔内感染及肠梗阻在内的术后并发症方面未显示出比CLA有任何明显优势。

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