预防性造口在低位直肠癌前切除术中应用价值的Meta分析
Chinese Journal of Current Advances in General Surgery(2012)
Abstract
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%CI:0.22~0.53,P<0.00001)和0.27(95%CI: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。
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Key words
Rectal neoplasms·Surgerical treatment·Defunctioning stoma·Low anterior resection·Meta-analysis
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