摘要
目的探讨预防性造口在低位直肠癌前切除中的应用价值。方法检索中国知网全文期刊数据库、Pubmed数据库、万方数据库2007年1月~2017年10月公开发表的关于预防性造口在直肠癌低位前切除中的应用相关文献和研究。结果共纳入符合标准的文献16篇,预防性造口组2654例,未造口组2939例。Meta分析结果显示,国内研究数据显示:预防性造口组与未造口组比较,未造口组有较高的吻合口瘘发生率(OR=0.20,95%CI[0.11~0.38],P<0.00001)。国外研究数据显示:预防性造口组与未造口组比较,未造口组有较高的吻合口瘘发生率(OR=0.34,95%CI[0.24~0.47],P<0.00001)。综合国内外研究数据显示:预防性造口组与未造口组比较,未造口组也有较高的吻合口发生率(OR=0.29,95%CI[0.22~0.39],P<0.00001)。结论无论国内和国外研究结果均显示预防性造口可以降低直肠癌低位前切除术后吻合口瘘的发生率,因此建议在行直肠癌低位前切除术中可以选择性用预防性造口。
Objective To investigate the value of prophylactic stoma in the preoperative anterior resection of low rectal cancer.Methods Relevant literatures and studies on the application of prophylactic stoma in low-grade anterior resection of rectal cancer were published from the Chinese Knowledge Database Full-text Journal Database,Pubmed Database,and Wanfang Database published from January 2007 to October 2017.Results A total of 16 articles that met the criteria were included,2654 in the prevention group and 2939 in the non-ostomy group.Meta-analysis showed that the data from domestic studies showed that the incidence of anastomotic leakage was higher in the non-ostomy group than in the non-ostomy group（OR=0.20,95%CI[0.11-0.38],P〈0.00001）.Foreign research data show that compared with the non-ostomy group,there is a higher incidence of anastomotic leakage in the non-ostomy group（OR=0.34,95%CI[0.24-0.47],P〈0.00001）.Comprehensive domestic and international research data show that compared with the non-ostomy group,the non-ostomy group also has a higher incidence of anastomotic leakage（OR=0.29,95%CI [0.22-0.39],P〈0.00001）.Conclusion Both domestic and foreign studies have shown that prophylactic stoma can reduce the incidence of anastomotic leakage after rectal cancer with low anterior resection.Therefore,it is recommended that prophylactic stoma can be selectively used during low anterior resection of rectal cancer.
作者
王君
王维帅
朱希良
周浩
贾婷
娄耀
WANG Jun;WANG Weishuai;ZHU Xiliang;ZHOU Hao;JIA Ting;LOU Yao(Department of General Surgery,Traditional Chinese Medicine Hospital of Pizhou City in Jiangsu Province,Pizhou 221331,China)
出处
《中国现代医生》
2018年第22期46-49,共4页
China Modern Doctor
关键词
直肠癌
低位前切除
预防性造口
吻合口瘘
META分析
Rectal cancer
Low anterior resection
Preventive stoma
Anastomotie fistula
Meta analysis
