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BiZact™ 低温解剖装置对扁桃体切除术相关术中及术后并发症的影响:系统评价和荟萃分析。

Effect of the BiZact™ Low-Temperature Dissecting Device on Intra- and Postoperative Morbidities Related to Tonsillectomy-A Systematic Review and Meta-Analysis.

机构信息

Department of Otorhinolaryngology-Head and Neck Surgery, Soonchunhyang University College of Medicine, Cheonan 14584, Republic of Korea.

Department of Physiology and Biomedical Engineering, Mayo Clinic, Rochester, MN 55905, USA.

出版信息

Medicina (Kaunas). 2024 Aug 29;60(9):1415. doi: 10.3390/medicina60091415.

Abstract

: We investigated the effects of using a BiZact™ device for tonsillectomy on operating time, intraoperative blood loss, postoperative bleeding rate, and pain through a meta-analysis of the relevant literature. : We reviewed studies retrieved from the databases of PubMed, SCOPUS, Google Scholar, Embase, Web of Science, and Cochrane up to March 2024. The results were analyzed following PRISMA guidelines. Six studies that compared the outcomes of patients receiving perioperative BiZact™ tonsillectomy with those in control groups (cold steel dissection or bipolar tonsillectomy) were included for this analysis of the outcomes, which included intraoperative bleeding and time, postoperative pain, and frequency of postoperative bleeding. : The operative time (SMD -11.5985, 95%CI [-20.3326; -2.8644], I = 99.5%) in the treatment group was significantly reduced compared to the control group. However, BiZact™ showed no significant efficacy in reducing intraoperative bleeding when compared with the control group (SMD -0.0480, 95%CI [-1.8200; 1.7240], I = 98.6%). Postoperative pain on day 1 (SMD -0.0885, 95%CI [-0.4368; 0.2598], I = 98.9%), day 3 (SMD -0.2118, 95%CI [-0.6110; 0.1873], I = 99.5%), and later than day 7 (SMD 0.0924, 95%CI [-0.2491; 0.4338], I = 98.6%) in the treatment group was not significantly reduced relative to the control group. When compared to the control group, BiZact™ did not reduce the incidence of secondary postoperative bleeding control in the operation room (OR 0.5711, 95%CI [0.2476; 1.3173], I = 32.1%), primary bleeding (OR 0.4514, 95%CI [0.0568; 3.5894], I = 0.0%), or all postoperative bleeding events (OR 0.8117, 95%CI [0.5796; 1.1368], I = 26.3%). : This study demonstrated that using the BiZact™ device for tonsillectomy significantly decreased the operative time but could not effectively reduce intraoperative bleeding or postoperative pain and bleeding.

摘要

我们通过对相关文献的荟萃分析,研究了使用 BiZact™ 设备进行扁桃体切除术对手术时间、术中失血量、术后出血率和疼痛的影响。

我们检索了截至 2024 年 3 月来自 PubMed、SCOPUS、Google Scholar、Embase、Web of Science 和 Cochrane 数据库的研究。结果按照 PRISMA 指南进行分析。纳入了 6 项研究,这些研究比较了接受围手术期 BiZact™ 扁桃体切除术的患者与对照组(冷钢解剖或双极扁桃体切除术)的结果,包括术中出血和时间、术后疼痛以及术后出血频率。

与对照组相比,治疗组的手术时间(SMD -11.5985,95%CI [-20.3326;-2.8644],I = 99.5%)显著缩短。然而,与对照组相比,BiZact™ 并未显示出在减少术中出血方面的显著疗效(SMD -0.0480,95%CI [-1.8200;1.7240],I = 98.6%)。与对照组相比,治疗组术后第 1 天(SMD -0.0885,95%CI [-0.4368;0.2598],I = 98.9%)、第 3 天(SMD -0.2118,95%CI [-0.6110;0.1873],I = 99.5%)和第 7 天以后(SMD 0.0924,95%CI [-0.2491;0.4338],I = 98.6%)的术后疼痛均无明显减轻。与对照组相比,BiZact™ 并不能降低手术室中继发性术后出血的控制率(OR 0.5711,95%CI [0.2476;1.3173],I = 32.1%)、原发性出血(OR 0.4514,95%CI [0.0568;3.5894],I = 0%)或所有术后出血事件(OR 0.8117,95%CI [0.5796;1.1368],I = 26.3%)。

本研究表明,使用 BiZact™ 设备进行扁桃体切除术可显著缩短手术时间,但不能有效减少术中出血或术后疼痛和出血。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d3c2/11433995/e8cdb0eb750d/medicina-60-01415-g001.jpg

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