Laparoscopic surgery: A qualified systematic review.
Laparoscopic surgery: A qualified systematic review.
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DOI：
10.5662/wjm.v5.i4.238
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发表时间：
2015-12-26
期刊：
影响因子：
--
通讯作者：
Hanisch, Ernst
中科院分区：
文献类型：
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作者：
Buia, Alexander;Stockhausen, Florian;Hanisch, Ernst
目的：回顾当前腹腔镜手术的应用，重点介绍不同领域的标准操作。方法：使用PubMed Advanced Search Builder进行全面检索。本次检索共检索到321篇文章。选择的出版物必须符合以下标准：综述文章、随机对照试验或讨论腹腔镜手术主题的荟萃分析。此外，还在Cochrane数据库和影响较大的期刊中手工搜索出版物。根据符合纳入标准的标准，总共纳入了82项研究结果。总体而言，403篇全文文章被审查。其中218篇因不符合纳入标准而被排除。结果：共有185篇相关文章符合当前关于腹腔镜手术的文献综述的搜索标准。文章涵盖了从第一次应用腹腔镜到它在过去几年中的巨大进步的时期。总体而言，与开放手术相比，该手术最大的优势是将对腹壁的损伤降至最低。在胆囊切除、胃底折叠术和肾上腺切除的病例中，该手术已成为黄金标准，但在随机对照试验中并未被证明为优于开放手术的技术。恢复更快，住院时间更短，恢复正常活动更快是腹腔镜手术最明显的优势。微创手术疗效肯定、有效率高、伤口感染率低、围手术期并发症少。结论：手术训练的改进以及器械、影像和外科技术的发展，大大提高了腹腔镜手术的安全性和可行性。
AIM: To review current applications of the laparoscopic surgery while highlighting the standard procedures across different fields.METHODS: A comprehensive search was undertaken using the PubMed Advanced Search Builder. A total of 321 articles were found in this search. The following criteria had to be met for the publication to be selected: Review article, randomized controlled trials, or meta-analyses discussing the subject of laparoscopic surgery. In addition, publications were hand-searched in the Cochrane database and the high-impact journals. A total of 82 of the findings were included according to matching the inclusion criteria. Overall, 403 full-text articles were reviewed. Of these, 218 were excluded due to not matching the inclusion criteria.RESULTS: A total of 185 relevant articles were identified matching the search criteria for an overview of the current literature on the laparoscopic surgery. Articles covered the period from the first laparoscopic application through its tremendous advancement over the last several years. Overall, the biggest advantage of the procedure has been minimizing trauma to the abdominal wall compared with open surgery. In the case of cholecystectomy, fundoplication, and adrenalectomy, the procedure has become the gold standard without being proven as a superior technique over the open surgery in randomized controlled trials. Faster recovery, reduced hospital stay, and a quicker return to normal activities are the most evident advantages of the laparoscopic surgery. Positive outcomes, efficiency, a lower rate of wound infections, and reduction in the perioperative morbidity of minimally invasive procedures have been shown in most indications.CONCLUSION: Improvements in surgical training and developments in instruments, imaging, and surgical techniques have greatly increased safety and feasibility of the laparoscopic surgical procedures.