| Objective:The clinical evidence-based medicine method was used to compare the differences between the complications of laparoscopic surgery and traditional laparotomy in the treatment of pelvic abscess,so as to provide a reference for clinical treatment to determine the surgical method.Methods:Through computer retrieval of foreign databases PubMed,EMBASE,Google scholar and Chinese academic journal full-text database(CNKI),Chinese biomedical literature database(CBM),Wanfang database(Wanfang-CSPD)and Weipu database(Vip-CSTJ),etc.Published domestic and international research literature on case control(RCT)of laparoscopic surgery and laparotomy for the treatment of pelvic abscess,screening out the documents that meet the evaluation criteria,and using meta-analysis method for 2012 to 2019 at home and abroad A quantitative and comprehensive analysis of 13 research literatures on laparoscopic surgery and laparotomy for the treatment of pelvic abscess.Result:A total of 13 Chinese and English literatures were included in this meta-analysis,including 11 Chinese literatures and 2 English literatures;a total of2706 patients were included,including 1250 patients in the laparoscopic group and1456 patients in the traditional laparotomy group.the study.Using Revman 5.3software for data analysis,the results are shown as follows:1.Incision infection: The OR value and 95% Cl in the study are distributed on the left side of the figure,OR = 0.26,95% Cl [0.18,0.37],the difference is significant(P <0.00001);it can be considered in the treatment of pelvic abscess In the laparoscopic group,there were fewer operative wound infections than in the laparotomy group.2.Intestinal injury: The OR value and 95% Cl in the study are distributed on the left side of the figure,OR = 0.25,95% Cl [0.06,1.01],the difference is significant(P= 0.03 <0.05);In pelvic abscesses,the risk of bowel injury was lower in the laparoscopic group than in the open group.3.Intestinal obstruction : The OR value and 95% Cl were distributed on the left side of the figure in the study,OR = 0.27,95% Cl [0.09,0.81],P = 0.02 <0.05;it can be considered that in the treatment of pelvic abscess,abdominal cavity Compared with the laparotomy group,the risk of operative intestinal obstruction was lower in the mirror group.4.Recurrence of pelvic abscess: The OR value and 95% Cl were distributed on the left side of the figure in the study,OR = 0.34,95% Cl [0.16,0.75],the difference was significant(P = 0.007 <0.01);In pelvic abscess,the risk of recurrence of pelvic abscess after laparoscopic group was higher than that in open group.5.Chronic pelvic pain : The OR value and 95% Cl were distributed on the left side of the figure in the study,OR = 0.35,95% Cl [0.15,0.83],P = 0.02 <0.05;it can be considered that in the treatment of pelvic abscess,abdominal cavity Compared with the laparotomy group,the risk of chronic pelvic pain is lower in the mirror group.6.Secondary pelvic infection: The OR values ? ? and 95% Cl were evenly distributed in the center of the figure during the study,OR = 0.51,95% Cl [0.15,1.74],P = 0.28> 0.05;it can be considered that in the treatment of pelvic abscess,the abdominal cavity Compared with the laparotomy group,there was no significant difference in the incidence of secondary pelvic infection after surgery.7.Urinary system injury : The OR value and 95% Cl were evenly distributed in the center of the figure during the study,OR = 0.96,95% Cl [0.33,2.84],P = 0.94>0.05;it can be considered that in the treatment of pelvic abscess,laparoscopic There was no significant difference in the occurrence of urinary system injury between the group and the open group.Conclusion:In the selection of surgical methods for pelvic abscess,the risk of incision infection,intestinal injury,intestinal obstruction,pelvic abscess recurrence and chronic pelvic pain is lower in the laparoscopic group than in the open group.However,there is no significant difference between the two surgical methods foroperative pelvic infection and urinary tract injury. |
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