Kil-Yong Lee, Jaeim Lee, Youn Young Park, Seong Taek Oh
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引用次数: 0
Abstract
Background: Polymeric clips are easy to apply, but whether they present more advantages than endoloops is unclear. This single-center, open-label, randomized controlled trial study was conducted to compare the advantages of using a polymeric clip versus an endoloop in terms of the surgical time.
Methods: Adult patients who were diagnosed with acute appendicitis without perforation on preoperative abdominal computed tomography and underwent laparoscopic appendectomy between August 6, 2019, and December 26, 2022, were included. Single-blinded randomization was performed in a 1:1 ratio between the endoloop and polymeric clip groups. The primary endpoint was the difference in surgery time between the polymeric clip and endoloop groups. The secondary endpoints were the difference in the application time of each instrument, difference in operation and anesthesia fees, as well as the frequency of complications.
Results: The completed trial included 104 and 103 patients in the polymeric clip and endoloop groups, respectively. The median surgery time with a polymeric clip was shorter than that with an endoloop; however, the difference was not significant (18 min 56 s vs 19 min 49 s, p = 0.426). Interestingly, the median time from applying the instrument to appendiceal cutting in the polymeric clip group was significantly shorter than that in the endoloop group (49.0 s vs 84.5 s, p < 0.001). No significant difference was observed between the two groups in terms of surgical (p = 0.120) and anesthetic (p = 0.719) costs, as well as the total number of postoperative complications (p > 0.999).
Conclusion: A polymeric clip is a safe instrument that can reduce the time from applying the instrument to appendiceal cutting, although it does not affect the overall surgical time and operation fee when performing laparoscopic appendectomy for uncomplicated appendicitis.
背景:聚合物夹子很容易应用，但它们是否比内环更有优势尚不清楚。这项单中心、开放标签、随机对照试验研究旨在比较使用聚合夹与内环在手术时间方面的优势。方法:纳入2019年8月6日至2022年12月26日期间，术前腹部计算机断层扫描诊断为急性阑尾炎且未穿孔并行腹腔镜阑尾切除术的成年患者。在endoloop组和聚合物夹组之间按1:1的比例进行单盲随机化。主要终点是聚合物夹组和endoloop组手术时间的差异。次要终点为各器械使用时间的差异、手术费用和麻醉费用的差异以及并发症的发生频率。结果:完成的试验包括104例和103例患者，分别为聚合物夹组和endoloop组。聚合物夹的中位手术时间比内环短;但差异无统计学意义(18分56秒vs 19分49秒，p = 0.426)。有趣的是，聚合物夹组从应用器械到阑尾切割的中位时间明显短于endoloop组(49.0 s vs 84.5 s, p 0.999)。结论:对于无并发症的阑尾炎进行腹腔镜阑尾切除术时，聚合物夹在不影响手术总时间和手术费用的情况下，是一种安全的器械，可减少从器械到阑尾切割的时间。试验注册号:KCT0004154。
期刊介绍：
The World Journal of Emergency Surgery is an open access, peer-reviewed journal covering all facets of clinical and basic research in traumatic and non-traumatic emergency surgery and related fields. Topics include emergency surgery, acute care surgery, trauma surgery, intensive care, trauma management, and resuscitation, among others.
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