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腹腔镜手术与开腹手术治疗盆腔脓肿并发症的系统评价和 Meta 分析。

Systematic Review and Meta-Analysis of Complications after Laparoscopic Surgery and Open Surgery in the Treatment of Pelvic Abscess.

机构信息

Department of Obstetrics and Gynecology, Taizhou First People's Hospital, Taizhou, Zhejiang 318020, China.

出版信息

Biomed Res Int. 2022 Jul 4;2022:3650213. doi: 10.1155/2022/3650213. eCollection 2022.

Abstract

BACKGROUND

Pelvic abscess surgery consists mostly of open laparotomy and laparoscopic surgery. Open surgery is regarded as a classic procedure. With the rise and promotion of laparoscopic indications in recent years, comparative studies of the two's postoperative effectiveness have been limited.

OBJECTIVE

To compare the clinical effects of laparoscopic exploratory surgery and open surgery in the treatment of pelvic abscess.

METHODS

Through computer searches of PubMed, EMBASE, Web of Science, China National Knowledge Infrastructure (CNKI), Wanfang, and Weipu databases, we found publicly available case-control research on laparoscopic surgery and open surgery for treating pelvic abscess. The papers that met the evaluation criteria were screened, and meta-analysis was used to look at 8 papers on laparoscopic surgery and open surgery for treating pelvic abscess from 2010 to 2021.

RESULTS

The results of this study showed that compared with the open laparotomy group, the incidence of laparoscopic group in the incision infection rate (RR = 0.29, 95% CI (0.20, 0.41), and < 0.00001), the incidence of intestinal injury (RR = 0.08, 95% CI (0.04, 0.14), and < 0.00001), incidence of intestinal obstruction (RR = 0.26, 95% CI (0.08, 0.90), and = 0.03 < 0.05), and postoperative pelvic abscess recurrence rate (RR = 0.34, 95% CI (0.13, 0.86), and = 0.02 < 0.05) are lower than open surgery, and the difference of these four items is statistically significant. There was no difference in the risk of urinary tract injury between laparoscopic surgery and open surgery (RR = 0.92, 95% CI (0.27, 3.17), and = 0.89 > 0.05).

CONCLUSION

In terms of incision infection, intestinal damage, intestinal obstruction, and recurrence of pelvic abscess, the laparoscopic group clearly outperforms the open group, and it merits clinical promotion and use.

摘要

背景

盆腔脓肿手术主要包括开腹手术和腹腔镜手术。开腹手术被认为是一种经典的手术方法。近年来,随着腹腔镜适应证的兴起和推广,对两种手术术后效果的比较研究较为有限。

目的

比较腹腔镜探查术与开腹手术治疗盆腔脓肿的临床效果。

方法

通过计算机检索 PubMed、EMBASE、Web of Science、中国知网(CNKI)、万方和维普数据库,查找公开发表的关于腹腔镜手术与开腹手术治疗盆腔脓肿的病例对照研究。筛选符合评价标准的文献,对 2010 年至 2021 年发表的 8 篇关于腹腔镜手术与开腹手术治疗盆腔脓肿的研究进行 Meta 分析。

结果

本研究结果显示,与开腹组相比,腹腔镜组的切口感染发生率(RR=0.29,95%CI(0.20,0.41), <0.00001)、肠损伤发生率(RR=0.08,95%CI(0.04,0.14), <0.00001)、肠梗阻发生率(RR=0.26,95%CI(0.08,0.90), = 0.03 <0.05)和术后盆腔脓肿复发率(RR=0.34,95%CI(0.13,0.86), = 0.02 <0.05)均低于开腹组,差异均有统计学意义。腹腔镜手术与开腹手术在尿路损伤风险方面无差异(RR=0.92,95%CI(0.27,3.17), = 0.89 >0.05)。

结论

在切口感染、肠损伤、肠梗阻和盆腔脓肿复发方面,腹腔镜组明显优于开腹组,值得临床推广应用。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/2de8/9273437/f26ece206637/BMRI2022-3650213.001.jpg

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