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腹腔镜与开腹子宫切除术对子宫内膜癌患者手术部位伤口感染影响的比较:一项荟萃分析。

Comparison of the effects of laparoscopic and open hysterectomy on surgical site wound infections in patients with endometrial cancer: A meta-analysis.

作者信息

Yang Nian, Zhou Fei

机构信息

Department of Obstetrics and Gynaecology, Sichuan Provincial People's Hospital, School of Medicine, University of Electronic Science and Technology of China, Chengdu, China.

出版信息

Int Wound J. 2023 Sep 24;21(2). doi: 10.1111/iwj.14415.

Abstract

This meta-analysis aimed to compare laparoscopic hysterectomy (LH) and open hysterectomy (OH) in terms of surgical site wound infection, length of hospital stay, and postoperative complications in patients with endometrial cancer (EC). PubMed, Embase, Cochrane Library, China National Knowledge Infrastructure, VIP, and Wanfang databases were comprehensively searched for studies on OH and LH for EC published between 2008 and July 2023, in any language. The literature was screened according to the inclusion and exclusion criteria, and the quality of the included case-control studies was assessed using the Newcastle-Ottawa Scale. Data were collated and analysed using Stata 17.0 software. A total of 1245 articles were screened according to the search strategy, and ultimately 15 studies were included in this meta-analysis, with a total of 1606 patients with EC, of which 751 were treated with LH and 855 with OH. The results showed that the rate of postoperative wound infection was significantly higher (OR: 0.290; 95% CI: 0.169-0.496, p < 0.001), the length of hospital stay was significantly longer (SMD: -1.976, 95% CI: -2.669 to -1.283, p < 0.001), and the incidence of postoperative complications was significantly higher (OR: 0.366; 95% CI: 0.280-0.478, p < 0.001) in the OH group than in the LH group. This study showed that LH was superior to OH for the treatment of EC and is associated with a lower rate of wound infection, shorter length of hospitalisation, and a reduced risk of complications. Thus, our findings support the choice of LH over OH for EC.

摘要

本荟萃分析旨在比较腹腔镜子宫切除术(LH)和开腹子宫切除术(OH)在子宫内膜癌(EC)患者手术部位伤口感染、住院时间和术后并发症方面的差异。全面检索了PubMed、Embase、Cochrane图书馆、中国知网、维普和万方数据库,以查找2008年至2023年7月间发表的关于EC的OH和LH的研究,不限语言。根据纳入和排除标准对文献进行筛选,并使用纽卡斯尔-渥太华量表评估纳入的病例对照研究的质量。使用Stata 17.0软件整理和分析数据。根据检索策略共筛选出1245篇文章,最终15项研究纳入本荟萃分析,共有1606例EC患者,其中751例接受LH治疗,855例接受OH治疗。结果显示,OH组术后伤口感染率显著更高(OR:0.290;95%CI:0.169 - 0.496,p < 0.001),住院时间显著更长(SMD:-1.976,95%CI:-2.669至-1.283,p < 0.001),术后并发症发生率显著更高(OR:0.366;95%CI:0.280 - 0.478,p < 0.001)。本研究表明,LH在治疗EC方面优于OH,且与较低的伤口感染率、较短的住院时间和降低的并发症风险相关。因此,我们的研究结果支持在EC治疗中选择LH而非OH。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/836a/10824626/3e1ee52dca13/IWJ-21-e14415-g002.jpg

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