肠系膜下动脉结扎方式对乙状结肠癌和直肠癌患者预后影响的Meta分析

Role of different ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery ：a meta-analysis

目的 评价肠系膜下动脉低位或高位结扎对乙状结肠癌和直肠癌患者术后5年生存率和手术死亡率的影响.方法 采用Meta分析的方法综合评价2009年12月1日前国内外公开发表的关于肠系膜下动脉低位或高位结扎对乙状结肠癌和直肠癌患者术后5年生存率、手术死亡率影响的文献.结果 筛选出符合纳入和排除标准的文献共7篇,其中低位结扎组与高位结扎组5年生存率比较,合并值OR＝0.87（95% CI：0.76～0.98,P＝0.02）;手术死亡率合并值（OR）＝1.26（95% CI：0.92～1.72,P＝0.15）.结论 高位结扎肠系膜下动脉的手术死亡率并不高于低位结扎,但可能提高乙状结肠癌和直肠癌患者术后5年生存率.

Objective To evaluate the effect of different ligation of the inferior mesenteric artery in sigmoid colon or rectal cancer surgery on 5-year overall survival rate and operative mortality. Methods The results of several 1iteratures from different countries on high or low ligation of the inferior mesenteric artery and prognosis were analyzed using meta-analysis. Results Seven studies were included. The 5-year overall surviva1 rate was compared between low and high ligation. The odd ratio （OR） for 5-year survival was 0.87（95% CI=0.76-0.98,P=0.02）, and the OR for perioperative mortality was 1.28（95% CI=0.94-1.75,P=0.19）. Conclusions High ligation of the inferior mesenteric artery may improve 5-year overall surviva1 rate. Perioperative mortality may not be influenced by the level of ligation.