在腹腔镜结直肠癌手术中采用 Pfannenstiel 切口提取标本的安全性：系统综述和荟萃分析

IF 1.6 4区医学 Q2 SURGERY

Videosurgery and Other Miniinvasive Techniques Pub Date : 2023-12-29 DOI:10.5114/wiitm.2023.134194

Jingjing Guo, Dong Yang, Bao Zhang, Xing Xu, Zhuo Yang, Yan Zhao, Zhichao Zheng, Xiangyu Meng, Tao Zhang

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引用次数: 0

摘要

引言 Pfannenstiel切口常用于妇科剖腹产手术；然而，在治疗结直肠癌的腹腔镜手术中使用Pfannenstiel切口提取标本的研究却很有限。材料和方法检索PubMed、Embase、Web of Science、Cochrane Library、CNKI、VIP和万方数据，检索截至2023年3月10日发表的研究；采用随机效应模型（RCT）和固定效应模型评估安全性。对手术时间、拔牙皮肤切口长度、总体并发症、浅表伤口感染、器官/间隙手术部位感染和切口疝进行了评估。与无 Pfannenstiel 组相比，Pfannenstiel 组在手术时间、切口长度、总体并发症、浅表伤口感染和器官/空间手术部位方面没有明显优势。然而，Pfannenstiel 切口有增加切口长度的趋势（SMD = 0.05；95% CI = -0.22 至 0.33；P = 0.71），其余五项（手术时间、总体并发症、切口疝、切口感染和器官/间隙手术部位感染）的结果都略微偏向于 Pfannenstiel 切口。值得一提的是，与无 Pfannenstiel 切口组相比，Pfannenstiel 切口组的切口疝（IH）可能更具优势。四项研究没有明确的偏倚风险，两项研究存在偏倚风险。结论我们的研究得出结论，Pfannenstiel切口具有良好的安全性记录，是结肠癌腹腔镜手术中提取标本的良好选择。用于腹腔镜手术标本提取的 Pfannenstiel 切口的切口疝发生率明显低于无 Pfannenstiel 切口。

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The safety of Pfannenstiel incision for specimen extraction in laparoscopic colorectal surgery for colorectal cancer: a systematic review and meta-analysis

Introduction
The Pfannenstiel incision is often used in gynecological Cesarean section; however, there is limited research on the use of the Pfannenstiel incision for specimen extraction in laparoscopic surgery for the treatment of colorectal cancer.

Aim
To evaluate the safety of using the Pfannenstiel incision for specimen extraction in laparoscopic surgery for colorectal cancer patients.

Material and methods
PubMed, Embase, Web of Science, Cochrane Library, CNKI, VIP and WanFangData were searched for studies published up to March 10, 2023; a random-effects model (RCT) and a fixed-effect model were used to evaluate the safety. Operative time, length of extraction skin incision, overall complications, superficial wound infection, organ/space surgical site infection and incisional hernia were evaluated.

Results
A total of 5 studies were included in this research. There were no significant advantages in operation time, length of the incision, overall complications, superficial wound infection and organ/space surgical site in the Pfannenstiel group compared to the no Pfannenstiel group. However, the Pfannenstiel incision has a tendency to increase the length of the incision (SMD = 0.05; 95% CI = –0.22 to 0.33; p = 0.71) and the results of the remaining five (operative time,overall complications,incisional hernia, incisional infection and organ/space surgical site infection) are slightly skewed toward the Pfannenstiel incision. It is worth mentioning that incisional hernia (IH) may have an advantage in the Pfannenstiel group compared to the no Pfannenstiel group. Four studies were not at clear risk of bias and two studies were at risk of bias.

Conclusions
Our study concludes that the Pfannenstiel incision has a good safety record and it is a good option for extracting specimens during laparoscopic surgery for colon cancer. The Pfannenstiel incision used for laparoscopic surgical specimen extraction has a significantly lower incidence of incisional hernia over no Pfannenstiel.

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来源期刊

Videosurgery and Other Miniinvasive Techniques 医学-外科

CiteScore

2.80

自引率

23.50%

发文量

审稿时长

12 weeks

期刊介绍： Videosurgery and other miniinvasive techniques serves as a forum for exchange of multidisciplinary experiences in fields such as: surgery, gynaecology, urology, gastroenterology, neurosurgery, ENT surgery, cardiac surgery, anaesthesiology and radiology, as well as other branches of medicine dealing with miniinvasive techniques.