JAMA Surg:机器人vs 腹腔镜补片腹疝修补术对患者术后疼痛的影响

2020-10-26 MedSci原创 MedSci原创

与传统的腹腔镜腹腔内补片腹疝修补相比,机器人修补后患者结果相似,但机器人手术的时间较长,成本效益较低

近年来,美国机器人腹腔内补片腹疝修补平台得到了迅速普及,但其与传统的腹腔镜手术相比,对患者临床结果的影响研究尚不充分。近日研究人员比较了机器人或腹腔镜补片腹疝修补对患者术后疼痛的影响。
本次研究在俄亥俄州克利夫兰市开展,为单盲、前瞻性随机临床试验,于2017年9月至2020年1月进行,最短随访时间为30天。原发性或切口中线腹股沟疝患者参与,预期宽度不超过7 cm,选择接受择期微创修复治疗。患者随机接受标准化腹腔镜或机器人腹股沟疝修补术,同时进行筋膜闭合和腹腔内补片。研究的主要终点为术后第一天NRS-11疼痛评估差异(0表示无疼痛,疼痛较强时增加点数,10表示最剧烈的疼痛)。次要终点包括患者报告的疼痛强度简表(3a)结果、疝气特定生活质量、手术时间、伤口发病率、复发率、住院时间和费用。
 
75例患者接受了微创疝修补术,其中36例腹腔镜手术,39例为机器人手术。组间基线人口学和疝特征相似。机器人手术的中位手术操作时间较长(146 vs 94分钟;P<0.001)。每个队列均有2例内脏损伤,但没有全厚肠切除术或计划外再手术。术后第0、1、7或30天NRS-11评分无显著性差异。具体来说,术后第一天的中位NRS-11评分相同( 5 vs 5)。同样,术后患者报告的3a评估结果、疝气特定生活质量评分、住院时间和并发症发生率相似。机器人手术的成本较高(总成本比,1.13 vs 0.97;P=0.03),较长的手术时间是导致成本增加的重要因素。
 
研究人员,与传统的腹腔镜腹腔内补片腹疝修补相比,机器人修补后患者结果相似,但机器人手术的时间较长,成本效益较低。
 
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    2020-11-01 jacob9231

    谢谢啦学习了

    0

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    2020-10-28 xue8602
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    2020-10-26 旺医

    顶刊就是顶刊,谢谢梅斯带来这么高水平的研究报道,我们科里同事经常看梅斯,分享梅斯上的信息

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