Buia Alexander, Stockhausen Florian, Hanisch Ernst
Alexander Buia, Florian Stockhausen, Department of General and Visceral Surgery, St. Elisabethen-Krankenhaus, Academic Teaching Hospital Goethe-University Frankfurt, D-60487 Frankfurt, Germany.
World J Methodol. 2015 Dec 26;5(4):238-54. doi: 10.5662/wjm.v5.i4.238.
To review current applications of the laparoscopic surgery while highlighting the standard procedures across different fields.
A comprehensive search was undertaken using the PubMed Advanced Search Builder. A total of 321 articles were found in this search. The following criteria had to be met for the publication to be selected: Review article, randomized controlled trials, or meta-analyses discussing the subject of laparoscopic surgery. In addition, publications were hand-searched in the Cochrane database and the high-impact journals. A total of 82 of the findings were included according to matching the inclusion criteria. Overall, 403 full-text articles were reviewed. Of these, 218 were excluded due to not matching the inclusion criteria.
A total of 185 relevant articles were identified matching the search criteria for an overview of the current literature on the laparoscopic surgery. Articles covered the period from the first laparoscopic application through its tremendous advancement over the last several years. Overall, the biggest advantage of the procedure has been minimizing trauma to the abdominal wall compared with open surgery. In the case of cholecystectomy, fundoplication, and adrenalectomy, the procedure has become the gold standard without being proven as a superior technique over the open surgery in randomized controlled trials. Faster recovery, reduced hospital stay, and a quicker return to normal activities are the most evident advantages of the laparoscopic surgery. Positive outcomes, efficiency, a lower rate of wound infections, and reduction in the perioperative morbidity of minimally invasive procedures have been shown in most indications.
Improvements in surgical training and developments in instruments, imaging, and surgical techniques have greatly increased safety and feasibility of the laparoscopic surgical procedures.
回顾腹腔镜手术的当前应用，同时强调不同领域的标准手术流程。
使用PubMed高级搜索构建器进行全面搜索。此次搜索共找到321篇文章。入选发表文章需满足以下标准：综述文章、随机对照试验或讨论腹腔镜手术主题的荟萃分析。此外，还在Cochrane数据库和高影响力期刊中进行了手工检索。根据符合纳入标准，共纳入82项研究结果。总体而言，共审查了403篇全文文章。其中，218篇因不符合纳入标准而被排除。
共确定了185篇相关文章，符合腹腔镜手术当前文献综述的搜索标准。文章涵盖了从首次腹腔镜应用到过去几年其巨大进展的时间段。总体而言，与开放手术相比，该手术最大的优势是将对腹壁的创伤降至最低。在胆囊切除术、胃底折叠术和肾上腺切除术的情况下，该手术已成为金标准，但在随机对照试验中并未被证明是优于开放手术的技术。恢复更快、住院时间缩短以及更快恢复正常活动是腹腔镜手术最明显的优势。在大多数适应症中，已显示出积极的结果、高效性、较低的伤口感染率以及微创手术围手术期发病率的降低。
手术培训的改进以及器械、成像和手术技术的发展极大地提高了腹腔镜手术的安全性和可行性。
