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开放手术与微创手术对前列腺手术患者术后伤口并发症的影响:一项荟萃分析。

Impact of open and minimally invasive surgery on postoperative wound complications in patients undergoing prostate surgery: A meta-analysis.

作者信息

Zhu Jialiang, Lu Ziwen, Cai Xianguo, Chen Wanbo

机构信息

Department of Urology, Taizhou Hospital of Zhejiang Province affiliated to Wenzhou Medical University, Taizhou, China.

出版信息

Int Wound J. 2024 Jan;21(1):e14367. doi: 10.1111/iwj.14367. Epub 2023 Sep 14.

Abstract

In this article, we analysed the therapeutic efficacy of open radical prostatectomy (ORP) and minimally invasive surgery (MIS) after operation for the treatment of post-operation complications. In summary, because of the broad methodology of the available trials and the low number of trials, the data were limited. The investigators combined the results of six of the 211 original studies. We looked up 4 databases: PubMed, EMBASE, Web of Science and the Cochrane Library. A total of six publications were selected. The main result was the rate of post-operation wound complications. Secondary results were the time of operation and the duration of hospitalization. Our findings indicate that the minimal invasive operation can decrease the incidence of wound infections (OR, 0.61; 95% CI: 0.42,0.90, p = 0.01), bleeding (MD, -293.09; 95% CI: -431.48, -154.71, p < 0.0001), and length of stay in the hospital compared with open surgery (MD, -1.85; 95% CI: -3.52, -0.17, p = 0.03), but minimally invasive surgery increased patient operative time (MD, 51.45; 95% CI: 40.99, 61.92, p < 0.0001). Compared with the open operation, the microinvasive operation has the superiority in the treatment of the wound complications following the operation of radical prostatic carcinoma. But the operation time of the microinvasive operation is much longer. Furthermore, there is a certain amount of bias among the various studies, so it is important to be cautious in interpretation of the findings.

摘要

在本文中,我们分析了开放性根治性前列腺切除术(ORP)和微创手术(MIS)术后对术后并发症的治疗效果。总之,由于现有试验的方法广泛且试验数量较少,数据有限。研究者合并了211项原始研究中的6项结果。我们检索了4个数据库:PubMed、EMBASE、科学网和考克兰图书馆。共筛选出6篇文献。主要结果是术后伤口并发症发生率。次要结果是手术时间和住院时长。我们的研究结果表明,与开放手术相比,微创手术可降低伤口感染发生率(OR,0.61;95%CI:0.42,0.90,p = 0.01)、出血情况(MD,-293.09;95%CI:-431.48,-154.71,p < 0.0001)以及住院时间(MD,-1.85;95%CI:-3.52,-0.17,p = 0.03),但微创手术会增加患者手术时间(MD,51.45;95%CI:40.99,61.92,p < 0.0001)。与开放手术相比,微创手术在治疗前列腺癌术后伤口并发症方面具有优势。但微创手术的手术时间要长得多。此外,各项研究之间存在一定程度的偏差,因此在解释研究结果时需谨慎。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4519/10788585/f18a795be780/IWJ-21-e14367-g003.jpg

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