摘要
目的：探讨骶前冲洗液类型、冲洗量与直肠癌前切除术后复发风险关系。方法：采用统计学软件对2013年10月18日前Medline（1980年1月至2013年10月）,Embase（1980年1月至2013年10月）,Wiley Online Library（1980年1月至2013年10月）等数据库收录的相关文献进行分析。结果：共筛选出8篇相关文献,包含患者919例,其中骶前冲洗者431例（46.9%）,未接受者488例（53.1%）,冲洗组复发率显著低于未冲洗组（OR=0.47,95%CI=0.26～0.85）;亚组分析发现,生理盐水冲洗后局部复发率显著降低（3.0%,8/265vs 8.3%,20/242）,差异显著（OR=0.34,95%CI=0.16～0.75）;骶前冲洗容量在1 500ml及以上者,冲洗组患者局部复发率显著降低（OR=0.38,95%CI=0.17～0.86）,而骶前冲洗容量在1 500ml以下者两组间局部复发率差异不显著（OR=0.60,95%CI=0.25～1.45）。结论：充分的骶前冲洗可降低直肠癌前切除术后局部复发风险达50%以上,1 500ml的生理盐水或应成为直肠癌前切除术后常规骶前冲洗量。
Objective： To investigate the association between irrigation fluids types’volumes of rectal washout and risk of local recurrence after anterior resection for cancer. Methods ： Relevant studies were identified by a search of Medline,Embase,Wiley Online Library and so on with no restrictions to October 18,2013,and included in the sys-tematic review and meta - analysis. Results ： Eight trials and 919 participants, of which 431 （46. 9% ） patients under-going rectal washout and 488（53. 1%） not, were included. The rate of local recurrence （ LR） （ 2. 19% , 8/287 ） in washout group was significantly lower than that in the no washout group （ OR = 0.47,95 % Cl = 0. 26 ？ 0. 85 ） . In sub- group,the LR rate（2.79% ,8/287） after intraoperative washout with saline solution was significantly lower than that in the control group（ OR = 0. 34, 95% Cl = 0. 16 ～ 0. 75 ）, so as that in the subgroup of washout with 1 500ml and a-bove in volume （8/265,3.0% vs 8. 3% ,20/242, OR = 0. 38,95% Cl = 0 . 17 ～ 0 . 8 6 ） , but not for the less than 1 500ml subgroup（ OR =0.60, 95% Cl = 0 .2 5 ～1 .4 5 ） . Conclusion： A thorough rectal washout can effec-tively reduce the risk of local recurrences in patients with resectable rectal cancer. 1 500ml and above saline solution should be recommended routinely in the prevention of local recurrence for rectal cancer.
出处
《现代肿瘤医学》
CAS
2016年第20期3256-3260,共5页
Journal of Modern Oncology
关键词
直肠癌
骶前冲洗
局部复发
META分析
rectal cancer,rectal washout,local recurrences,Meta - analysis
