Jamil Munawar, Niaz Khurram, Tahir Fatima
Department of Surgery, Quaid-e-Azam Medical College/ Bahawal Victoria Hospital, Bahawalpur, Pakistan.
J Pak Med Assoc. 2018 Oct;68(10):1478-1482.
To assess the safety profile of closed and open method of pneumoperitonium by comparing access and closure time during laparoscopic surgery and complications.
This quassi-experimental study was conducted at Bahawal Victoria Hospital, Bahawalpur, Pakistan, from September 15, 2013, to September 15, 2016, and comprised patients who were block-randomised into two equal groups. The first half constituted Group A where pneumoperitonium was created by closed method, while the latter half was designated as Group B where the open method was employed. The two groups were compared for access, closure time and complications. SPSS 23 was used for data analysis.
There were 850 patients, with 425(50%) in each of the two groups. The overall mean age was 38.78±5.41 years, and 667(78%) were females. The mean access time in Group A was 6.58±1.78min and in Group B it was 5.49±1.82 min. The mean closure time was 7.60±2.12min in Group A and 6.91±1.40min in Group B (p<0.00). Access problem in Group A was significantly high (p=0.001). Abdominal wall complications were 13(3.05%) in Group A and 24(5.64%) in Group B (p=0.064). Visceral injury happened in 5(1.17%) patients in Group A and 1(0.23%) in Group B (p=0.101).
Open method of pneumoperitoneum was found to be safe and less time-consuming compared to the closed method.
通过比较腹腔镜手术中的穿刺及关闭时间和并发症情况，评估闭合式与开放式气腹方法的安全性。
这项准实验研究于2013年9月15日至2016年9月15日在巴基斯坦巴哈瓦尔布尔的巴哈瓦尔维多利亚医院进行，纳入的患者被整群随机分为两组。前半部分为A组，采用闭合式建立气腹；后半部分为B组，采用开放式建立气腹。比较两组的穿刺、关闭时间及并发症情况。使用SPSS 23进行数据分析。
共有850例患者，两组各425例（50%）。总体平均年龄为38.78±5.41岁，女性667例（78%）。A组平均穿刺时间为6.58±1.78分钟，B组为5.49±1.82分钟。A组平均关闭时间为7.60±2.12分钟，B组为6.91±1.40分钟（p<0.00）。A组穿刺问题显著更高（p=0.001）。A组腹壁并发症为13例（3.05%），B组为24例（5.64%）（p=0.064）。A组有5例（1.17%）患者发生内脏损伤，B组有1例（0.23%）（p=0.101）。
与闭合式方法相比，开放式气腹方法被发现更安全且耗时更少。
