腹腔镜阑尾切除术、残端闭合与圈套器：一项荟萃分析。
Laparoscopic appendectomy, stump closure and endoloops: A meta-analysis.
作者信息
Zorzetti Noemi, Lauro Augusto, Bellini Maria Irene, Vaccari Samuele, Dalla Via Barbara, Cervellera Maurizio, Cirocchi Roberto, Sorrenti Salvatore, D'Andrea Vito, Tonini Valeria
机构信息
Department of General Surgery, Ospedale Civile A Costa, Porretta Terme 40046, Italy.
Department of Surgical Sciences, Sapienza University, Rome 00161, Italy.
出版信息
World J Gastrointest Surg. 2022 Sep 27;14(9):1060-1071. doi: 10.4240/wjgs.v14.i9.1060.
BACKGROUND
Acute appendicitis (AA) is one of the main indications for urgent surgery. Laparoscopic appendectomy (LA) has shown advantages in terms of clinical results and cost-effectiveness, even if there is still controversy about different devices to utilize, especially with regards to the endoloop (EL) endostapler (ES) when it comes to stump closure.
AIM
To compare safety and cost-effectiveness of EL ES.
METHODS
From a prospectively maintained database, data of 996 consecutive patients treated by LA with a 3 years-follow up in the department of Emergency General Surgery - St Orsola University Hospital, Bologna (Italy) were retrieved. A meta-analysis was performed in terms of surgical complications, in comparison to the international literature published from 1995 to 2021.
RESULTS
The meta-analysis showed no evidence regarding wound infections, abdominal abscesses, and total post-operative complications, in terms of superiority of a surgical technique for the stump closure in LA.
CONCLUSION
Even when AA is complicated, the routine use of EL is safe in most patients.
背景
急性阑尾炎（AA）是紧急手术的主要指征之一。腹腔镜阑尾切除术（LA）在临床效果和成本效益方面已显示出优势，即使在使用不同器械方面仍存在争议，尤其是在残端闭合时使用内圈套器（EL）和腔内吻合器（ES）方面。
目的
比较EL和ES的安全性及成本效益。
方法
从一个前瞻性维护的数据库中，检索了意大利博洛尼亚圣奥索拉大学医院急诊普通外科连续996例接受LA治疗且随访3年的患者的数据。与1995年至2021年发表的国际文献相比，就手术并发症进行了荟萃分析。
结果
荟萃分析表明，在LA中，就残端闭合的手术技术优越性而言，没有证据表明在伤口感染、腹腔脓肿和术后总并发症方面存在差异。
结论
即使AA病情复杂，大多数患者常规使用EL也是安全的。
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