预防性造口在低位直肠癌前切除术中应用价值的Meta分
析
马从超;吴胜文
【期刊名称】《中国现代普通外科进展》 【年(卷),期】2012(015)012
【摘要】目的:评估预防性造口在低位直肠癌全系膜切除术中的价值.方法:检索PubMed和Embase数据库中有关低位直肠癌术中实施预防性造口的相关研究和文献,将预防性造口组与未造口组患者术后吻合口瘘的发生率和与吻合口瘘相关的再手术率进行比较.结果:5项最近的研究符合纳入标准,累计病例878例.Meta分析表明预防性造口能明显降低吻合口瘘及再手术的发生率,合并风险率分别为0.34(95％ Cl:0.22 ～ 0.53,P＜0.00001)和0.27 (95％Cl:0.16～0.48,P＜0.00001),差异有统计学意义.结论:预防性造口可有效的降低吻合口瘘的发生率和与吻合口瘘相关的再手术率,且不影响术后直肠肠管功能；但是否影响患者远期生存率和术后生活质量,目前尚无定论.%Objective: The necessity of a defunctioning stoma in low anterior resection with total mesorectal excision for rectal cancer remains controversial. This meta-analysis evaluates the advantages of prophylactic stomas in patients undergoing low anterior resection and assesses postoperative outcomes of patients with or without a defunctioning stoma. Methods: Studies and relevant literatures regarding the formation of defunctioning stomas after low anterior resection were secirched though PubMed and Embase. The rates of anastomotic leakage and re-operation related to leakage with
or without defunctioning stoma were pooled and compared using a meta-analysis. The risk ratios were calculated with 95% confidence intervals to evaluate the influence of defunctioning stomas. Results： Five recent studies including 878 patients in total were included in this meta-analysis. These studies demonstrated that defunctioning stomas significantly reduced the rate of postoperative anastomotic leakage and reoperation after low anterior resection, the pooled risk ratio was 0.34(95% CI: 0.22～0.53, P＜0.00001) and 0.27 (95% CI: 0.16～0.48, ＜0.00001), respectively. Conclusions: Defunctioning stomas can be useful to minimize the rate of anastomotic leakage and re-operation related to leakage. Furthermore, anorectal function was not affected. However, the influence of a defunctioning stoma on long-term mortality and the quality of life in patients treated for rectal cancer is inconclusive. 【总页数】5页(963-967)
【关键词】直肠肿瘤;外科治疗;预防性造口;低位切除;Meta分析 【作者】马从超;吴胜文
【作者单位】江苏省建湖县人民医院 胃肠外科 江苏 盐城224700;江苏省建湖县人民医院 胃肠外科 江苏 盐城224700 【正文语种】中文 【中图分类】R735.3+7 【文献来源】
https://www.zhangqiaokeyan.com/academic-journal-cn_chinese-
journal-current-advances-general-surgery_thesis/0201234358918.html 【相关文献】
1.预防性造口在直肠癌低位前切除术中的应用价值 [J], 亢杰; 王云海; 阿不都外力·吾守尔; 徐艺可
2.预防性横结肠造口在直肠癌低位前切除术中的应用价值 [J], 杨贵义
3.预防性造口在直肠癌低位前切除中应用价值Meta分析 [J], 王君; 王维帅; 朱希良; 周浩; 贾婷; 娄耀
4.预防性横结肠造口在腹腔镜辅助直肠癌低位前切除术中的应用研究 [J], 周臻涛; 张耀明; 罗宇峰
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预防性造口在低位直肠癌前切除术中应用价值的Meta分析
