摘要
目的评价结直肠癌术后吻合口瘘对局部复发、远处转移和术后总体生存率的影响。方法通过检索PubMed／Medline、医学文摘资料库（EMBASE）、Springger、Googlescholar、中国知网（CNKI）、中国生物医学文献数据库（CBM）、万方数据库，收集1970年1月至2011年6月关于结直肠癌术后吻合口瘘相关中、英文临床对照研究。采用Cochrane协作网提供的RevMan5．0软件，对病例的局部复发、远处转移和术后总体生存率进行Meta分析。结果经过质量评估筛选出符合纳入标准的文献15篇，共有18225例患者列入研究。其中术后有吻合口瘘1425例，无吻合口瘘16800例。有吻合口瘘者与无吻合口瘘者比较，局部复发的OR=2．47（95％C／1．72～3．55，P〈0．01）。远处转移的OR：1．18（95％C／0．98～1．43，P=0．08），5年生存率OR=1．68（95％C／1．36～2．07，P〈0．01）。结论结直肠癌术后吻合口瘘是不良的预后因素，可以增加肿瘤局部复发率和降低生存率。
Objective To study the local recurrence, distant recurrence and survival rate of anastomotic leak after surgery in patients with colorectal cancer. Methods Chinese and English related studies published from January 1970 to June 2011 were searched in PubMed/Medline, Excerpta medica database （EMBASE）, Springger, Google scholar, China national knowledge infrastructure （CNKI）, China biomedical literature database （CBM）, Wanfang data. All controlled trials related to anastomotic leak after surgery in patients with colorectal cancer were retrieved. Outcomes were evaluated including local recurrence, distant recurrence and survival rate, then Mate-analysis was performed using RevMan 5.0 software provided by the Cochrane network. Results Fifteen studies were included, including a total of 18 225 patients. There were 1 425 patients with anastomotic leak and 16 800 patients without anastomotic leak. The patients with anastomotic leak were compared with patients without anastomotic leak. The OR value of local recurrence was 2.47 （95% CI 1.72 - 3.55, P 〈 0.01）, the OR value of distant recurrence was 1.18 （95% CI 0.98 - 1.43, P = 0.08）, and the OR value of 5- year survival rate was 1.68 （95% CI 1.36 - 2.07, P 〈 0.01）. Conclusions Anastomotic leak after surgery is a bad prognosis factor in patients with colorectal cancer. It can increase the local recurrence rate, and decrease survival rate.
出处
《中国医师进修杂志》
2015年第12期890-894,共5页
Chinese Journal of Postgraduates of Medicine
基金
黑龙江省自然科学基金（D201169）
