结直肠(结肠肛管)吻合术后袢式回肠造口与袢式横结肠造口比较的Meta分析

Postoperative of Temporary Loop Ileostomy (LI) Versus Loop Colostomy (LC) for Temporary Decompression of Colorectal and/or Coloanal Anastomoses: a Meta Analysis

目的比较结直肠或结肠肛管吻合术后暂时性袢式回肠造口与暂时性袢式横结肠造口的术后并发症。方法检索Elsevier、MEDLINE、EMBAS、中国数字化期刊全文数据库(CNKI)、万方数据库及维普中文科技期刊全文数据库,按所制定的纳入和排除标准收集国内外截止2012年3月12日公开发表的有关对暂时性袢式回肠造口与袢式横结肠造口(作为结直肠吻合口和/或结肠肛管吻合口的暂时性减压造口)的并发症进行比较的随机对照试验与观察性研究文献。统计软件采用stata11.0及RevMan5.0。结果共纳入12篇英文文献,共累计袢式回肠造口病例604例,袢式横结肠造口病例605例。本分析提示袢式回肠造口较袢式横结肠造口可减少造口脱垂[OR=0.15(95%CI:0.06,0.36),P<0.05],伤口感染[OR=0.31(95%CI:0.17,0.57),P<0.05]及切口疝[OR=0.21(95%CI:0.07,0.62),P<0.05]的发生。结论袢式回肠造口(作为结直肠吻合口和/或结肠肛管吻合口的暂时性减压造口)较袢式横结肠造口更具优势。

Objective Comparing the complications of postoperative of temporary loop ileostomy (LI) and loop colostomy (LC) for temporary decompression of colorectal and/or coloanal anastomoses. Methods The articles of all randomized controlled trials and observation studies about the complications of postoperative of temporary loop ileostomy (LI)and loop colostomy (LC) for temporary decompression of colorectal and/or coloanal anastomoses were retrieved (up to March12,2012) from Elsevier,MEDLINE,EMBAS,China National Knowledge Infrastructure (CNKI),Wanfang Data,and VIP information database. We use Stata11. 0 & RevMan5. 0 for all the analysis and evaluation. Results Based on the selection criteria,12 articles of randomized controlled trials and observation studies were selected. The LI cases and LC cases were 604 and 605 respectively. This analysis suggests that LI can reduce some complications than LC,such as prolapse[OR = 0.15 (95% CI: 0. 06,0. 36),P < 0. 05],wound infection[OR = 0. 31 (95% CI: 0. 17,0. 57),P < 0. 05]and hernia[OR = 0. 21 (95% CI: 0. 07,0. 62),P <0. 05]. Conclusions: Temporary loop ileostomy (LI) for temporary decompression of colorectal and/or coloanal anastomoses is better than loop colostomy (LC).