女性腹腔镜腹股沟疝修补术中保留或横断子宫圆韧带的Meta分析
Preserving or transecting the round ligament of uterus in female laparoscopic inguinal hernia repair:A Meta-analysis
施万程 1王超 1陈杨 1张育超 1范开虎 1何嘉伦 1赖东明1
作者信息
- 1. 516600 汕尾,中山大学附属孙逸仙纪念医院深汕中心医院胃肠外科
- 折叠
摘要
目的 评估女性腹股沟疝腔镜修补术中保留或横断子宫圆韧带的优缺点.方法 从PubMed、Embase、Cochrane Library、Web of Science、百度学术、中国知网、万方数据库中收集2000年1 月至 2023 年 8 月发表的相关研究,用RevMan5.3 进行数据统计分析,主要的统计指标包括手术时间、术后血清肿、术后疼痛、住院天数、术中出血量、术后疝复发.结果 最终纳入 11 篇随机对照研究,共包含 1 443 例患者,术中保留子宫圆韧带共 746 例,横断子宫圆韧带 697 例.女性腹股沟疝腔镜修补术中,保留或切除子宫圆韧带手术时间(MD=6.69,95%CI:3.48～9.91,P<0.000 1)差异有统计学意义;术后血清肿(OR=0.71,95%CI:0.38～1.30,P=0.27)、术后疼痛(OR=1.56,95%CI:0.76～3.24,P=0.23)、住院天数(MD=-0.58,95%CI:-1.55～0.40,P=0.25)、术中出血量(MD=-1.05,95%CI:-2.66～0.76,P=0.23)、术后疝复发(OR=0.47,95%CI:0.07～3.36,P=0.44)差异均无统计学意义.结论 女性腹股沟疝腹腔镜修补术中保留子宫圆韧带可使手术时间延长.在不明显影响疗效、康复的前提下,应该积极保留子宫圆韧带的完整,避免损伤其功能.保留或横断子宫圆韧带造成的其他临床效果,需要更多临床数据、研究.
Abstract
Objective To evaluate the advantages and disadvantages of preserving or transecting the round ligament of uterus during laparoscopic inguinal hernia repair in women.Methods Relevant studies were collected from PubMed,Embase,Cochrane Library,Web of Science,Baidu Academic,CNKI and Wanfang database on the preservation or transection of the round ligament of the uterus during endoscopic repair in female inguinal hernia.The data were statistically analyzed with RevMan5.3.The primary outcomes included the operation time,postoperative seroma,postoperative pain,hospital stay,bleeding volume and recurrence of hernia.Results 11 randomized controlled trials including 1 443 patients(749 patients in experiment group,697 patients in control group)were collected.Preserving or transecting the round ligament of the uterus during laparoscopic inguinal hernia repair in women,the operation time(MD=6.69,95%CI:3.48-9.91,P<0.000 1)was statistically significant.There was no statistical difference in postoperative seroma(OR=0.71,95%CI:0.38-1.30,P=0.27),postoperative pain(OR=1.56,95%CI:0.76-3.24,P=0.23),hospital stay(MD=-0.58,95%CI:-1.55-0.40,P=0.25),bleeding volume(MD=-1.05,95%CI:-2.66-0.76,P=0.23)and recurrence of hernia(OR=0.47,95%CI:0.07-3.36,P=0.44).Conclusions During laparoscopic inguinal hernia repair in women,preserving the round ligament of uterus can prolong the operation time.Without obviously affecting the efficacy and recovery,the integrity of the uterine round ligament should be actively preserved to avoid damaging its function.Other clinical effects caused by preserving or transecting the round ligament of uterus need more clinical data and research.
关键词
子宫圆韧带/腹腔镜/疝,腹股沟/疝修补术/女性Key words
Round ligament of uterus/Laparoscopes/Hernia,inguinal/Hernia repair/Female引用本文复制引用
基金项目
广东省医学科学技术研究项目(A2023176)
出版年
2024
NETL
NSTL
万方数据