自体纤维蛋白封闭剂（Vivostat）能否降低胰体尾切除术后胰瘘的发生率？——配对分析
Does autologous fibrin sealant (vivostat) reduce the incidence of postoperative pancreatic fistula after distal pancreatectomy? - a matched pairs analysis.
作者信息
Luu Andreas Minh, Braumann Chris, Uhl Waldemar, Janot-Matuschek Monika, Herzog Torsten
机构信息
Department of Surgery, Katholisches Klinikum Bochum - St. Josef Hospital, Ruhr University Bochum, Bochum, Germany.
出版信息
Acta Chir Belg. 2021 Feb;121(1):16-22. doi: 10.1080/00015458.2019.1658354. Epub 2019 Aug 30.
BACKGROUND
Postoperative pancreatic fistula (POPF) is the most common complication following distal pancreatectomy. This retrospective study investigated the effects of autologous fibrin sealant (Vivostat) in reducing the incidence of POPF after distal pancreatectomy.
METHODS
A matched pairs analysis was performed to compare the incidence of clinically relevant POPF of 41 patients who underwent a distal pancreatectomy with application of autologous fibrin sealant (Vivostat) with a historical control group.
RESULTS
Clinically relevant POPF were present in 11 patients in the study group (27%) and in 13 patients in the control group (32%, = .639). No patient of the study group required emergency angiographic treatment for postoperative hemorrhage due to POPF, whereas three patients were identified in the control group (7%, = .079).
CONCLUSIONS
POPF cannot be prevented under treatment with autologous fibrin sealant (Vivostat). We observed the tendency of a lower rate of postoperative pancreatic hemorrhage due to POPF. However, prospective randomized controlled studies are required.
背景
术后胰瘘（POPF）是远端胰腺切除术后最常见的并发症。这项回顾性研究调查了自体纤维蛋白封闭剂（Vivostat）在降低远端胰腺切除术后POPF发生率方面的作用。
方法
进行配对分析，以比较41例行远端胰腺切除术并应用自体纤维蛋白封闭剂（Vivostat）的患者与历史对照组中临床相关POPF的发生率。
结果
研究组有11例患者出现临床相关POPF（27%），对照组有13例患者出现（32%，P = 0.639）。研究组没有患者因POPF导致术后出血而需要紧急血管造影治疗，而对照组有3例患者（7%，P = 0.079）。
结论
自体纤维蛋白封闭剂（Vivostat）治疗无法预防POPF。我们观察到因POPF导致的术后胰腺出血率有降低的趋势。然而，需要进行前瞻性随机对照研究。
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