食管切除术中加行幽门引流术的必要性及安全性的Meta分析

A meta analysis of necessity and safety of pyloroplasty or pyloromyotomy versus no drainage in gastric reconstruction after esophagectomy

目的 系统评价食管切除术中加行幽门引流术（幽门成形、幽门括约肌切开术）的必要性及安全性.方法 通过电子搜索PubMed、Cochrane图书馆、Medline、Ovid、中国生物医学文献光盘数据、中文科技期刊全文数据库、CNKI数据库,对2000年1月至2010年12月有关食管切除术中加行幽门引流术（幽门成形术或幽门括约肌切开术）的随机对照实验及回顾性队列研究进行评价,并用RevMan 5.0进行Meta分析.结果 共纳入文献5篇,1018例患者.荟萃分析结果 显示：术后胃排空障碍、吻合口瘘、吸入性肺炎、其他呼吸系统并发症发生率,幽门引流组与对照组比较两组间差异无统计学意义（P〉0.05）.结论 食管切除胃代食管吻合术中行幽门引流术不能够有效降低术后胃排空障碍及其他术后并发症的发生率.

Objective To assess the necessity and safety of pyloroplasy or pyloromyotomy after esophagectomy. Methods Pubmed, Cochrane Library, Medline, Ovid, CBM, VIP and CNKI were searched to collect randomized controlled trials and retrospective chart review studies about pyloroplasty or pyloro- myotomy after esophagectomy from Jan 2000 to Dec 2010. The quality of included trials was assessed. Da- ta were extracted and analyzed with RevMan 5.0 software. Results After screening 5 studies were brought into the review that included 1018 patients. There was no significant difference in delayed gastric empty- ing, esophagogastric anastomotic leak, aspiration pneumonia or pulmonary complications between the pylor- ie drainage group and no-pyloric drainage group. Conclusion Pyloric drainage does not decrease the rate of gastric emptying or other complications in gastric reconstruction after esophagectomy.