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Ann Surgery: 改良Blumgart 褥式缝合与常规间断缝合在胰肠吻合胰十二指肠切除术中的效果比较

2019-01-11 MedSci MedSci原创

有研究报道,胰十二指肠切除术(PJ )中Blumgart吻合术的褥式缝合可以降低胰十二指肠切除(PD)术后临床相关的术后胰瘘(POPF)率。但是还没有研究证实这一观点,因此,本文旨在通过随机对照试验(RCT)评估胰十二指肠切除术(PJ)期间褥式缝合线和空肠血清肌层(改良Blumgart法)是否可降低胰十二指肠切除术后临床相关的术后胰瘘(POPF)的发生率(PD)

背景及目的: 
有研究报道,胰十二指肠切除术(PJ )中Blumgart吻合术的褥式缝合可以降低胰十二指肠切除(PD)术后临床相关的术后胰瘘(POPF)率。但是还没有研究证实这一观点,因此,本文旨在通过随机对照试验(RCT)评估胰十二指肠切除术(PJ)期间褥式缝合线和空肠血清肌层(改良Blumgart法)是否可降低胰十二指肠切除术后临床相关的术后胰瘘(POPF)的发生率(PD)

方法:  
研究人员收集了2013年6月至2017年5月间在和歌山医科大学附属医院就诊的224例PD患者。入选患者随机分为间断缝合或改良Blumgart 褥式缝合。主要终点是基于胰瘘标准国际研究组的B / C级POPF发病率。

结果: 
患者随机分为间断缝合(103例)或改良Blumgart 褥式缝合线(107例),并通过意向治疗进行分析。间断缝合组7例(6.8%)发生B / C级POPF ,褥式缝合组11例(10.3%)(P = 0.367)。两组内90天内死亡率均为0。间断缝合组与改良Blumgart 褥式缝合组术后并发症无明显差异。

结论: 
PJ手术中胰腺实质和空肠血清肌层的改良Blumgart 褥式缝合与常规间断缝合相比并未减少临床相关的POPF。

原始出处:

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    2019-06-17 chg121
  5. [GetPortalCommentsPageByObjectIdResponse(id=1900693, encodeId=14dc19006938b, content=<a href='/topic/show?id=4e0c3566952' target=_blank style='color:#2F92EE;'>#十二指肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35669, encryptionId=4e0c3566952, topicName=十二指肠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7460166, createdName=zhang92560, createdTime=Tue Jul 02 18:26:00 CST 2019, time=2019-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1780395, encodeId=b6681e80395e3, content=<a href='/topic/show?id=91c23542fb' target=_blank style='color:#2F92EE;'>#Blumgart#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3542, encryptionId=91c23542fb, topicName=Blumgart)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Tue Nov 12 12:26:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021650, encodeId=be8c202165001, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Tue Oct 22 08:26:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877735, encodeId=78b018e773513, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Mon Jun 17 19:26:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632786, encodeId=7b0d1632e8699, content=<a href='/topic/show?id=10a09e25096' target=_blank style='color:#2F92EE;'>#间断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97250, encryptionId=10a09e25096, topicName=间断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c86a21951359, createdName=TZF0811, createdTime=Fri Jun 07 15:26:00 CST 2019, time=2019-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877109, encodeId=277118e710919, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Mar 27 13:26:00 CST 2019, time=2019-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357076, encodeId=8554135e07622, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jan 13 12:26:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046724, encodeId=af651046e247b, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Jan 12 00:26:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-06-07 TZF0811
  6. [GetPortalCommentsPageByObjectIdResponse(id=1900693, encodeId=14dc19006938b, content=<a href='/topic/show?id=4e0c3566952' target=_blank style='color:#2F92EE;'>#十二指肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35669, encryptionId=4e0c3566952, topicName=十二指肠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7460166, createdName=zhang92560, createdTime=Tue Jul 02 18:26:00 CST 2019, time=2019-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1780395, encodeId=b6681e80395e3, content=<a href='/topic/show?id=91c23542fb' target=_blank style='color:#2F92EE;'>#Blumgart#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3542, encryptionId=91c23542fb, topicName=Blumgart)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Tue Nov 12 12:26:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021650, encodeId=be8c202165001, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Tue Oct 22 08:26:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877735, encodeId=78b018e773513, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Mon Jun 17 19:26:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632786, encodeId=7b0d1632e8699, content=<a href='/topic/show?id=10a09e25096' target=_blank style='color:#2F92EE;'>#间断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97250, encryptionId=10a09e25096, topicName=间断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c86a21951359, createdName=TZF0811, createdTime=Fri Jun 07 15:26:00 CST 2019, time=2019-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877109, encodeId=277118e710919, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Mar 27 13:26:00 CST 2019, time=2019-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357076, encodeId=8554135e07622, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jan 13 12:26:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046724, encodeId=af651046e247b, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Jan 12 00:26:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
  7. [GetPortalCommentsPageByObjectIdResponse(id=1900693, encodeId=14dc19006938b, content=<a href='/topic/show?id=4e0c3566952' target=_blank style='color:#2F92EE;'>#十二指肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35669, encryptionId=4e0c3566952, topicName=十二指肠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7460166, createdName=zhang92560, createdTime=Tue Jul 02 18:26:00 CST 2019, time=2019-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1780395, encodeId=b6681e80395e3, content=<a href='/topic/show?id=91c23542fb' target=_blank style='color:#2F92EE;'>#Blumgart#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3542, encryptionId=91c23542fb, topicName=Blumgart)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Tue Nov 12 12:26:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021650, encodeId=be8c202165001, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Tue Oct 22 08:26:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877735, encodeId=78b018e773513, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Mon Jun 17 19:26:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632786, encodeId=7b0d1632e8699, content=<a href='/topic/show?id=10a09e25096' target=_blank style='color:#2F92EE;'>#间断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97250, encryptionId=10a09e25096, topicName=间断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c86a21951359, createdName=TZF0811, createdTime=Fri Jun 07 15:26:00 CST 2019, time=2019-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877109, encodeId=277118e710919, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Mar 27 13:26:00 CST 2019, time=2019-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357076, encodeId=8554135e07622, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jan 13 12:26:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046724, encodeId=af651046e247b, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Jan 12 00:26:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-01-13 zhaojie88
  8. [GetPortalCommentsPageByObjectIdResponse(id=1900693, encodeId=14dc19006938b, content=<a href='/topic/show?id=4e0c3566952' target=_blank style='color:#2F92EE;'>#十二指肠#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=73, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=35669, encryptionId=4e0c3566952, topicName=十二指肠)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=7460166, createdName=zhang92560, createdTime=Tue Jul 02 18:26:00 CST 2019, time=2019-07-02, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1780395, encodeId=b6681e80395e3, content=<a href='/topic/show?id=91c23542fb' target=_blank style='color:#2F92EE;'>#Blumgart#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=3542, encryptionId=91c23542fb, topicName=Blumgart)], attachment=null, authenticateStatus=null, createdAvatar=https://thirdwx.qlogo.cn/mmopen/vi_32/Q0j4TwGTfTIuNQXObUwZmFG3VcZa2uhFq27sY7vfTowUhQCgRj2bj1odUibMF4sFXpuRLf6IE5t5yGVDSiaOoOcQ/132, createdBy=1e622500088, createdName=ms1065684921169360, createdTime=Tue Nov 12 12:26:00 CST 2019, time=2019-11-12, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=2021650, encodeId=be8c202165001, content=<a href='/topic/show?id=31e8e9669d' target=_blank style='color:#2F92EE;'>#GER#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=7966, encryptionId=31e8e9669d, topicName=GER)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=48732500158, createdName=12498c32m68暂无昵称, createdTime=Tue Oct 22 08:26:00 CST 2019, time=2019-10-22, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877735, encodeId=78b018e773513, content=<a href='/topic/show?id=b013169237f' target=_blank style='color:#2F92EE;'>#surgery#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=75, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=16923, encryptionId=b013169237f, topicName=surgery)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=d7db99, createdName=chg121, createdTime=Mon Jun 17 19:26:00 CST 2019, time=2019-06-17, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1632786, encodeId=7b0d1632e8699, content=<a href='/topic/show?id=10a09e25096' target=_blank style='color:#2F92EE;'>#间断#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=74, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=97250, encryptionId=10a09e25096, topicName=间断)], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=c86a21951359, createdName=TZF0811, createdTime=Fri Jun 07 15:26:00 CST 2019, time=2019-06-07, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1877109, encodeId=277118e710919, content=<a href='/topic/show?id=67c5319121e' target=_blank style='color:#2F92EE;'>#切除术#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=61, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=31912, encryptionId=67c5319121e, topicName=切除术)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=9d8a96, createdName=doctorzheng, createdTime=Wed Mar 27 13:26:00 CST 2019, time=2019-03-27, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1357076, encodeId=8554135e07622, content=<a href='/topic/show?id=b0702e84b9' target=_blank style='color:#2F92EE;'>#ART#</a>, beContent=null, objectType=article, channel=null, level=null, likeNumber=64, replyNumber=0, topicName=null, topicId=null, topicList=[TopicDto(id=2784, encryptionId=b0702e84b9, topicName=ART)], attachment=null, authenticateStatus=null, createdAvatar=, createdBy=4c37265, createdName=zhaojie88, createdTime=Sun Jan 13 12:26:00 CST 2019, time=2019-01-13, status=1, ipAttribution=), GetPortalCommentsPageByObjectIdResponse(id=1046724, encodeId=af651046e247b, content=疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的, beContent=null, objectType=article, channel=null, level=null, likeNumber=96, replyNumber=0, topicName=null, topicId=null, topicList=[], attachment=null, authenticateStatus=null, createdAvatar=null, createdBy=f0620, createdName=CHANGE, createdTime=Sat Jan 12 00:26:00 CST 2019, time=2019-01-12, status=1, ipAttribution=)]
    2019-01-12 CHANGE

    疗效只是效果的众多方面之一,还要看对患者的获益,包括生活质量等因素共同决定效果的

    0

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