腹腔镜和开腹全结直肠切除回肠储袋肛管吻合术并发症文献分析

Document Analysis of Complications of Laparoscopic Surgery and Open Surgery with Ileal Pouch anal Anastomosis

目的:探讨腹腔镜和开腹行全结直肠切除回肠储袋肛管吻合出现术后并发症的危险性。方法:检索、收集已发表的关于腹腔镜和开腹两种方法行全结直肠切除回肠储袋肛管吻合术的对照研究,按meta分析要求,应用Review Manager 4.2软件对其结果进行分析,计算腹腔镜组与开腹组术后并发症危险性的优势比(OR)、95%可信区间(CI)及P值。结果:腹腔镜组术后总并发症、肠梗阻、吻合口漏及尿路感染发生率高于开腹组,但P值均>0.05;术后腹腔脓肿、切口感染、肺感染及再次手术干预的发生率低于开腹组,但P值均>0.05。结论:腹腔镜行全结直肠切除回肠储袋肛管吻合术是安全的,可行的。

Objective To explore the risk of postoperative complications of laparoscopic surgery and open surgery with ileal pouch anal anastomosis.Methods The published control study included two different methods with ileal pouch anal anastomosis,laparoscopic surgery and laparotomic surgery,was searched and collected.The literature was strictly selected based on the demand of meta-analysis,and its results were analyzed by Review Manager 4.2 software.The odds ratio （OR）,95% confidence interval （95% CI）,and P value were calculated to assess the risk of postoperative complications of laparoscopic surgery and open surgery with IPAA.Results The incidences of total complications,ileus,anastomotic leak and urinary tract infection were higher of laparoscopic surgery with IPAA compared with open surgery,but the inferiority was of no significant difference between them （P〉0.05）.The incidences of intra-abdominal abscess,wound infection,pulmonary infection and surgical reintervention were lower of laparoscopic surgery with IPAA compared with open surgery,but the superiority was of no significant difference between them （P〉0.05）.Conclusion Laparoscopic surgery with IPAA is safe and feasible.