Zhang Jing, Liu Xiaonan, Wang Wei, Gui Songbai, Cao Lei
Nursing, Beijing Tiantan Hospital, Capital Medical University, Beijing, CHN.
Neurosurgery, Beijing Tiantan Hospital, Capital Medical University, Beijing, CHN.
Cureus. 2023 Dec 23;15(12):e50987. doi: 10.7759/cureus.50987. eCollection 2023 Dec.
Objective Endoscopic transnasal skull base surgery is a valuable technique used in the surgical treatment of various skull base pathologies. In such surgeries, the reconstruction of the skull base is crucial for surgical success and minimizing complications. This study presents a new side-support surgical tray designed to improve the exposure of the lateral femoral surgical area during surgery, enhancing surgical efficiency and reducing the risk of surgical complications. The study compared this innovative tray stand with the conventional double-sided support tray stand to evaluate its impact on surgical procedures and complications. Materials and methods The study prospectively analyzed 248 endoscopic transnasal skull base surgeries requiring lateral femoral autologous tissue harvesting. One hundred fifty-eight cases were performed using the side-support surgical tray stand (experimental group), while 90 cases used the conventional double-sided support tray stand (control group). Various parameters were evaluated, including satisfaction scores of surgeons, circulating nurses, instrument nurses, and anesthetists, as well as objective outcomes such as surgical duration and the incidence of complications. Results Surgeons in the experimental group expressed higher satisfaction with the surgical field exposure and the portability of the surgical tray stand compared to the control group. Likewise, circulating nurses in the experimental group reported greater satisfaction with the installation and portability, surpassing that of the control group (< 0.01). Although the stability of instrument nurses in the experimental group was slightly less than that of the control group, it had no discernible impact on surgical cooperation. Anaesthesiologists in the experimental group exhibited higher satisfaction regarding the convenience of intraoperative monitoring and management than their counterparts in the control group. The average duration required for intraoperative autologous tissue harvesting in the experimental group was significantly shorter than in the control group ( < 0.01). Furthermore, the incidence of postoperative wound infections and intracranial infections in the experimental group was notably lower than in the control group (would infections, = 0.046; intracranial infection, = 0.025). Conclusion The novel side-support surgical tray stand effectively improves surgical exposure, convenience, and safety while reducing the risk of surgical site and intracranial infections. It also shortens surgical duration and lowers complication rates, making it a suitable choice for clinical application.
目的 鼻内镜经鼻颅底手术是用于治疗各种颅底病变的一种重要技术。在这类手术中,颅底重建对于手术成功及减少并发症至关重要。本研究提出一种新型侧支撑手术托盘,旨在改善手术过程中外侧股骨手术区域的暴露情况,提高手术效率并降低手术并发症风险。该研究将这种创新的托盘支架与传统的双侧支撑托盘支架进行比较,以评估其对手术操作和并发症的影响。
材料与方法 本研究前瞻性分析了248例需要采集外侧股骨自体组织的鼻内镜经鼻颅底手术。158例使用侧支撑手术托盘支架(实验组),而90例使用传统的双侧支撑托盘支架(对照组)。评估了各种参数,包括外科医生、巡回护士、器械护士和麻醉师的满意度评分,以及诸如手术时长和并发症发生率等客观结果。
结果 与对照组相比,实验组的外科医生对手术视野暴露和手术托盘支架的便携性表示更高的满意度。同样,实验组的巡回护士对其安装和便携性的满意度更高,超过了对照组(<0.01)。尽管实验组器械护士的稳定性略低于对照组,但对手术配合没有明显影响。实验组的麻醉医生对术中监测和管理的便利性表现出比对照组更高的满意度。实验组术中自体组织采集所需的平均时长明显短于对照组(<0.01)。此外,实验组术后伤口感染和颅内感染的发生率明显低于对照组(伤口感染,=0.046;颅内感染,=0.025)。
结论 新型侧支撑手术托盘支架有效改善了手术暴露、便利性和安全性,同时降低了手术部位和颅内感染的风险。它还缩短了手术时长并降低了并发症发生率,使其成为临床应用的合适选择。