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腹腔镜尾状叶切除术的手术结果:一项系统评价和荟萃分析。

Procedural outcomes of laparoscopic caudate lobe resection: A systematic review and meta-analysis.

作者信息

Hajibandeh Shahab, Kotb Ahmed, Evans Louis, Sams Emily, Naguib Andrew, Hajibandeh Shahin, Satyadas Thomas

机构信息

Cardiff Liver Unit, University Hospital of Wales, Cardiff and Vale NHS Trust, Cardiff, United Kingdom.

Department of General Surgery, Glan Clwyd Hospital, Rhyl, United Kingdom.

出版信息

Ann Hepatobiliary Pancreat Surg. 2023 Feb 28;27(1):6-19. doi: 10.14701/ahbps.22-045. Epub 2022 Oct 17.

Abstract

A systematic review was conducted in compliance with PRISMA statement standards to identify all studies reporting outcomes of laparoscopic resection of benign or malignant lesions located in caudate lobe of liver. Pooled outcome data were calculated using random-effects models. A total of 196 patients from 12 studies were included. Mean operative time, volume of intraoperative blood loss, and length of hospital stay were 225 minutes (95% confidence interval [CI], 181-269 minutes), 134 mL (95% CI, 85-184 mL), and 7 days (95% CI, 5-9 days), respectively. The pooled risk of need for intraoperative transfusion was 2% (95% CI, 0%-5%). It was 3% (95% CI, 1%-6%) for conversion to open surgery, 6% (95% CI, 0%-19%) for need for intra-abdominal drain, 1% (95% CI, 0%-3%) for postoperative mortality, 2% (95% CI, 0%-4%) for biliary leakage, 2% (95% CI, 0%-4%) for intra-abdominal abscess, 1% (95% CI, 0%-4%) for biliary stenosis, 1% (95% CI, 0%-3%) for postoperative bleeding, 1% (95% CI, 0%-4%) for pancreatic fistula, 2% (95% CI, 1%-5%) for pulmonary complications, 1% (95% CI, 0%-4%) for paralytic ileus, and 1% (95% CI, 0%-4%) for need for reoperation. Although the available evidence is limited, the findings of the current study might be utilized for hypothesis synthesis in future studies. They can be used to inform surgeons and patients about estimated risks of perioperative complications until a higher level of evidence is available.

摘要

按照PRISMA声明标准进行了一项系统评价,以确定所有报告肝尾状叶良性或恶性病变腹腔镜切除术结果的研究。使用随机效应模型计算汇总结果数据。纳入了来自12项研究的196例患者。平均手术时间、术中失血量和住院时间分别为225分钟(95%置信区间[CI],181 - 269分钟)、134毫升(95%CI,85 - 184毫升)和7天(95%CI,5 - 9天)。术中输血需求的汇总风险为2%(95%CI,0% - 5%)。转为开放手术的风险为3%(95%CI,1% - 6%),腹腔引流需求为6%(95%CI,0% - 19%),术后死亡率为1%(95%CI,0% - 3%),胆漏为2%(95%CI,0% - 4%),腹腔脓肿为2%(95%CI,0% - 4%),胆管狭窄为1%(95%CI,0% - 4%),术后出血为1%(95%CI,0% - 3%),胰瘘为1%(95%CI,0% - 4%),肺部并发症为2%(95%CI,1% - 5%),麻痹性肠梗阻为1%(95%CI,0% - 4%),再次手术需求为1%(95%CI,0% - 4%)。尽管现有证据有限,但本研究结果可用于未来研究中的假设合成。在获得更高水平的证据之前,它们可用于告知外科医生和患者围手术期并发症的估计风险。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/77b0/9947369/21f597e4fe5e/ahbps-27-1-6-f1.jpg

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