Department of Surgery, Madigan Army Medical Center, Tacoma, WA, USA.
Department of Surgery, MultiCare Allenmore Hospital, Tacoma, WA, USA.
Am J Surg. 2020 May;219(5):776-779. doi: 10.1016/j.amjsurg.2020.02.055. Epub 2020 Feb 29.
Currently, no evidence compares outcomes for techniques utilizing surgical specimen extractions bags versus unprotected extraction.
Evaluation of sleeve gastrectomies performed at two high-volume centers. Cases where an extraction bag was used (+EB) were compared to bag-less extraction (-EB). Outcomes included operative contamination, surgical site infections and extraction-site hernias.
674 patients were evaluated (417 in the +EB group and 257 in the -EB group). Preoperative characteristics were similar between groups. There was a trend toward shorter operative times with the -EB group (-EB = 100 min vs + EB = 106 min, p = 0.07). Gross spillage was documented as a contaminated case in 0.4% of -EB cases compared to 1.2% in +EB cases (p = 0.51). Two superficial infections were appreciated (1.2% = +EB vs 0.7% = -EB, p = 0.7) with one post-operative abscess in the -EB group (p = 0.61). One post-operative hernia was seen in each group (p = 0.62).
Bag-less extraction is a safe, resource conscious method that may potentially decreased operative time.
目前，尚无证据比较使用手术标本提取袋与无保护提取的技术的结果。
评估两个高容量中心进行的袖状胃切除术。将使用提取袋的病例（+EB）与无袋提取的病例（-EB）进行比较。结果包括手术污染、手术部位感染和提取部位疝。
共评估了 674 例患者（+EB 组 417 例，-EB 组 257 例）。两组患者的术前特征相似。-EB 组的手术时间有缩短的趋势（-EB = 100 分钟 vs +EB = 106 分钟，p = 0.07）。-EB 组有 0.4%的病例记录为明显的 gross spillage（污染病例），而+EB 组为 1.2%（p = 0.51）。+EB 组有 2 例浅表感染（1.2%），-EB 组有 1 例术后脓肿（p = 0.61）。两组各有 1 例术后疝（p = 0.62）。
无袋提取是一种安全且节约资源的方法，可能会缩短手术时间。
