术前肠道准备能否减少全膀胱切除尿流改道术后并发症发生概率的Meta分析

Bowel preparation versusno mechanical bowel preparation for patients undergoing cystectomy and urinary diversion:A Meta-analysis

目的系统评价比较严格的肠道准备和无肠道准备对于减少全膀胱切除尿流改道术后并发症发生概率的差异。方法计算机检索PubMed、EMBASE和Cochrane Library数据库的英文文献,通过Meta分析比较有无肠道准备两组间术后并发症发生概率的差异。结果共有3个随机对照研究和4个队列研究纳入分析评价,包括636例患者。两组在术后出现死亡、伤口感染、肠梗阻、脓毒血症、吻合口漏、伤口裂开的概率差异无统计学意义(P>0.1,=0)。结论全膀胱切除尿流改道术前行肠道准备与不行肠道准备相比,在术后并发症的发生概率上无明显差别。

Objective To evaluate the efficacy of comprehensive mechanical bowel preparation （BP） and no mechanical bowel preparation （No BP） in prevention of postoperative complications in elective urinary diversion surgery by using ileum. Methods We searched PubMed, EMBASE and the Cochrane Library. We performed a Meta-analysis to distinguish overall differ- ences between the two groups. Results Our literature search yielded three randomized controlled trials and four cohort studies, involving a total of 636 patients. There was no significant difference between the comprehensive bowel preparation and no bowel preparation in wound infection, mortality, ileus, sepsis, anastomotic leakage, wound dehiscence. Conclusion Our Meta-analysis suggested that the use of comprehensive bowel preparation for urinary diversion surgery with ileum does not offer any significant ad- vantage over no bowel preparation.