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比较内镜夹与内镜圈套器闭合残端对腹腔镜阑尾切除术患者手术时间和并发症的影响:一项随机临床试验。

Comparison the effect of stump closure by endoclips versus endoloop on the duration of surgery and complications in patients under laparoscopic appendectomy: A randomized clinical trial.

作者信息

Sadat-Safavi Seyed Abas, Nasiri Shirzad, Shojaiefard Abolfazl, Jafari Mehdi, Abdehgah Ali Ghorbani, Notash Aidin Yghoobi, Soroush Ahmadreza

机构信息

Research Center for Improvement of Surgical Outcomes and Procedures, Shariati Hospital, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

J Res Med Sci. 2016 Oct 18;21:87. doi: 10.4103/1735-1995.192503. eCollection 2016.

Abstract

BACKGROUND

Laparoscopic appendectomy is a well-described surgical technique. However, concerns still exist regarding whether the closure of the appendiceal stump should be done with a clip, an endoloop, or other techniques. In this study, the effect of stump closure on duration of surgery and complications by endoclips was compared with endoloop in patients under laparoscopic appendectomy. The study was carried out as a prospective randomized clinical trial between 2013 and 2015 in Shariati Hospital of Tehran.

MATERIALS AND METHODS

Seventy-six patients under laparoscopic appendectomy were enrolled and randomly assigned to receive either endoclips or endoloop for stump closure. The results in terms of the operating time, length of hospital stay, and the complications were compared and analyzed between two groups. After collecting the essential data by using a checklist and examination of patients, the data were analyzed with SPSS.

RESULTS

The mean age was 23.13 ± 5.07 years and 44.7% of the patients were male. Moreover, in this study, it was seen that the mean duration of surgery was 23.2 min versus 21.5 min in endoloop and endoclips groups, respectively ( = 0.021). There was no difference between hospital stay among two groups ( > 0.05). Furthermore, the complications were same in two groups ( > 0.05).

CONCLUSION

The effect of stump closure with endoloop versus endoclips is not different for complications, but the duration of surgery was shorter in endoclips method. Both methods could be used based on the opinion of the surgeon without expecting a statistically significant difference in the results.

摘要

背景

腹腔镜阑尾切除术是一种已被充分描述的外科技术。然而,对于阑尾残端的闭合是使用夹子、内镜圈套器还是其他技术,仍存在一些担忧。在本研究中,对接受腹腔镜阑尾切除术的患者,比较了使用内镜夹与内镜圈套器进行残端闭合对手术时间和并发症的影响。该研究于2013年至2015年在德黑兰沙里亚蒂医院作为一项前瞻性随机临床试验进行。

材料与方法

纳入76例行腹腔镜阑尾切除术的患者,并随机分配接受内镜夹或内镜圈套器进行残端闭合。比较并分析两组在手术时间、住院时间和并发症方面的结果。通过使用检查表收集基本数据并对患者进行检查后,使用SPSS对数据进行分析。

结果

平均年龄为23.13±5.07岁,44.7%的患者为男性。此外,在本研究中,发现内镜圈套器组和内镜夹组的平均手术时间分别为23.2分钟和21.5分钟(P = 0.021)。两组之间的住院时间没有差异(P>0.05)。此外,两组的并发症相同(P>0.05)。

结论

内镜圈套器与内镜夹进行残端闭合在并发症方面的效果没有差异,但内镜夹法的手术时间更短。两种方法均可根据外科医生的意见使用,无需期望结果有统计学上的显著差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/aafe/5244687/d50f2e7a8dd7/JRMS-21-87-g001.jpg

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