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犬腹腔镜及腹腔镜辅助手术相关并发症的系统评价

A systematic review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs.

作者信息

Maurin Marie-Pauline, Mullins Ronan A, Singh Ameet, Mayhew Philipp D

机构信息

School of Veterinary Medicine, University College Dublin, Dublin, Ireland.

Department of Clinical Studies, Ontario Veterinary College, University of Guelph, Guelph, Ontario, Canada.

出版信息

Vet Surg. 2020 Jun;49 Suppl 1:O5-O14. doi: 10.1111/vsu.13419. Epub 2020 Apr 25.

Abstract

OBJECTIVE

To evaluate and report the quality of the scientific literature reporting complications associated with laparoscopic and laparoscopic-assisted procedures in client-owned or healthy research dogs and to report and illustrate laparoscopic complications related to individual organ systems.

STUDY DESIGN

Systematic review.

ANIMALS

Client-owned or healthy research dogs.

METHODS

A literature review was performed by using PubMed and CAB abstracts for English-language studies providing descriptions of complications related to laparoscopic and laparoscopic-assisted procedures in dogs. Study selection used PRISMA (Preferred Reporting Items for Systematic reviews and Meta-Analyses) guidelines. Quality assessment was performed by using a MINORS (Methodological Items for Non-Randomized Studies) scoring system and a grading scale of level of evidence. Descriptive statistics were used.

RESULTS

In total, 741 manuscripts were identified, with 64 manuscripts eligible for data extraction and quality assessment. The most represented organ system was the female genital tract, represented by 22 (34.4%) studies. The most commonly reported intraoperative and postoperative complications were related to abdominal entry and portal incisions, respectively. In 53 of 54 non-randomized studies, high risk of bias was found. Forty-eight (75%) studies provided level III or IV evidence.

CONCLUSION

This report provides an updated review of complications related to laparoscopic and laparoscopic-assisted procedures in dogs, classified by organ system. The overall quality of evidence was low, limiting direct comparison of complication rates between studies.

CLINICAL SIGNIFICANCE

There is a need for implementation of standardized criteria for defining complications, study time frames and greater numbers of high quality prospective randomized trials in veterinary laparoscopy to permit comparison of complication and conversion rates between published studies and across organ systems.

摘要

目的

评估并报告关于客户拥有的或健康的实验犬腹腔镜及腹腔镜辅助手术相关并发症的科学文献质量,并报告和阐述与各个器官系统相关的腹腔镜并发症。

研究设计

系统评价。

动物

客户拥有的或健康的实验犬。

方法

通过使用PubMed和CAB文摘对英文研究进行文献综述,这些研究提供了犬腹腔镜及腹腔镜辅助手术相关并发症的描述。研究选择采用PRISMA(系统评价和Meta分析的首选报告项目)指南。使用MINORS(非随机研究的方法学项目)评分系统和证据水平分级量表进行质量评估。采用描述性统计方法。

结果

共识别出741篇手稿,其中64篇符合数据提取和质量评估要求。涉及最多的器官系统是雌性生殖道,有22项研究(占34.4%)。最常报告的术中及术后并发症分别与腹部穿刺和穿刺孔切口有关。在54项非随机研究中的53项中,发现存在高偏倚风险。48项研究(占75%)提供了III级或IV级证据。

结论

本报告提供了按器官系统分类的犬腹腔镜及腹腔镜辅助手术相关并发症的最新综述。证据的总体质量较低,限制了不同研究间并发症发生率的直接比较。

临床意义

在兽医腹腔镜手术中,需要实施标准化的并发症定义标准、研究时间框架,并开展更多高质量的前瞻性随机试验,以便能够比较已发表研究之间以及不同器官系统之间的并发症和中转开腹率。

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