Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the ...Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the wound and harm to the patient due to the retractor were reviewed. Methods : A search was conducted using the following databases: EMBASE, PubMed, BIOSIS, Engineering Village, Web of Science, Best practice, Science Direct, CRCnet BASE, Proquest, Wiley Online Library, and Comprehensive Biomaterial. Results : What the articles found were then narrowed down to those which matched the objective of the review. This resulted in ten articles to review. Two reviewers reviewed and summarized the articles. Femoral neuropathy was found to be a common complication due to Retractors. Other outcomes analysed or studied were found to be infected, postoperative pain and exposure provided. Femoral neuropathy can be estimated to occur at a rate between 2.6% and 7.5% in open pelvic and abdominal surgeries. The Alexis O-ring retractor was found to lower the required morphine intake following surgery when compared to the Belfour retractor. Conclusions : There is a lack of high quality/high levels of evidence studies that have been conducted on Retractors. Femoral neuropathy is the outcome most commonly documented in relation to Retractors. Surgeons need to be aware about the use and implementations of the retractors. Care should be taken in protecting the blades and during long surgery relocating retractors should be considered.展开更多
目的比较溃疡性结肠炎（UC）腹腔镜手术与开腹手术的安全性和有效性。方法外文数据库检索词：Ulcerative Colitis OR Inflammatory Bowel Disease AND Laparoscopy AND Open Surgery OR Open Procedure。中文数据库检索词：炎症性肠病O...目的比较溃疡性结肠炎（UC）腹腔镜手术与开腹手术的安全性和有效性。方法外文数据库检索词：Ulcerative Colitis OR Inflammatory Bowel Disease AND Laparoscopy AND Open Surgery OR Open Procedure。中文数据库检索词：炎症性肠病OR溃疡性结肠炎AND腹腔镜AND开腹手术。检索1992年1月至2008年5月发表的相关英文或中文全文文献,检索出符合入选标准的对照研究16项共计923例患者．采用固定效应模型和随机效应模型对UC腹腔镜手术与开腹手术的安全性和有效性指标进行Meta分析。结果与开腹手术相比，UC的腹腔镜手术明显缩短了开始进食时间（P〈0．01）和术后住院天数（P〈0．01），减少了术后总并发症发生率（P〈0．01），但延长了手术时间（P〈0．05）。在肠功能恢复时间、再次手术率、腹腔脓肿、吻合口瘘、肠梗阻、切口感染、术中出血量和死亡率方面未见明显优势。中转开腹手术率为4．2％。结论溃疡性结肠炎腹腔镜手术是安全、可行的，且术后短期恢复较快。展开更多
文摘Objectives : A systematic review was undertaken to evaluate the effectiveness of incision retention available to surgeons conducting open abdominal or pelvic surgeries. Both the ability of the retractor to retain the wound and harm to the patient due to the retractor were reviewed. Methods : A search was conducted using the following databases: EMBASE, PubMed, BIOSIS, Engineering Village, Web of Science, Best practice, Science Direct, CRCnet BASE, Proquest, Wiley Online Library, and Comprehensive Biomaterial. Results : What the articles found were then narrowed down to those which matched the objective of the review. This resulted in ten articles to review. Two reviewers reviewed and summarized the articles. Femoral neuropathy was found to be a common complication due to Retractors. Other outcomes analysed or studied were found to be infected, postoperative pain and exposure provided. Femoral neuropathy can be estimated to occur at a rate between 2.6% and 7.5% in open pelvic and abdominal surgeries. The Alexis O-ring retractor was found to lower the required morphine intake following surgery when compared to the Belfour retractor. Conclusions : There is a lack of high quality/high levels of evidence studies that have been conducted on Retractors. Femoral neuropathy is the outcome most commonly documented in relation to Retractors. Surgeons need to be aware about the use and implementations of the retractors. Care should be taken in protecting the blades and during long surgery relocating retractors should be considered.
文摘目的比较溃疡性结肠炎（UC）腹腔镜手术与开腹手术的安全性和有效性。方法外文数据库检索词：Ulcerative Colitis OR Inflammatory Bowel Disease AND Laparoscopy AND Open Surgery OR Open Procedure。中文数据库检索词：炎症性肠病OR溃疡性结肠炎AND腹腔镜AND开腹手术。检索1992年1月至2008年5月发表的相关英文或中文全文文献,检索出符合入选标准的对照研究16项共计923例患者．采用固定效应模型和随机效应模型对UC腹腔镜手术与开腹手术的安全性和有效性指标进行Meta分析。结果与开腹手术相比，UC的腹腔镜手术明显缩短了开始进食时间（P〈0．01）和术后住院天数（P〈0．01），减少了术后总并发症发生率（P〈0．01），但延长了手术时间（P〈0．05）。在肠功能恢复时间、再次手术率、腹腔脓肿、吻合口瘘、肠梗阻、切口感染、术中出血量和死亡率方面未见明显优势。中转开腹手术率为4．2％。结论溃疡性结肠炎腹腔镜手术是安全、可行的，且术后短期恢复较快。
