肌肉减少症对食管癌术后并发症影响的Meta分析

A Meta-analysis of postoperative complications related to preoperative sarcopenia in patients with esophageal cancer

目的:Meta分析术前肌肉减少症对食管癌术后并发症的影响。方法:检索Pub Med、Embase、中国生物医学文献服务系统、中国期刊全文数据库、维普和万方数据库,收集建库至2017年4月公开发表的相关研究。应用Rev Man 5.3软件进行Meta分析。结果:纳入6个队列研究共1 158例食管癌手术患者,合并术前肌肉减少症547例(47.2%),BMI(MD=-2.48,95%CI:-3.36^-1.60,P<0.000 01)、VC%(MD=-5.88,95%CI:-8.76^-3.00,P<0.000 1)和FEV1.0%(MD=-3.33,95%CI:-5.89^-0.77,P=0.01)低于无肌肉减少症者,肺部并发症(RR=1.77,95%CI:1.10~2.84,P=0.02)和吻合口瘘(RR=1.47,95%CI:1.10~1.98,P=0.010)的发生风险增高。结论:术前存在肌肉减少症的食管癌患者BMI较低,同时肺功能低下,术后发生肺部感染、吻合口瘘的风险增加。

Objective：To analyze the postoperative complications which related to preoperative sarcopenia in patients with esophageal cancer.Methods：The published papers related to patients with esophageal cancer and sarcopenia were searched in the PubMed,Embase,SinoMed,CNKI,VIP and Wanfang databases from their inception to April 2017.Meta-analysis was conducted by using RevMan 5.3.Results：6 projects with 1 158 patients undergone esophagectomy were included,547 （47.2%） patients with preoperative sarcopenia.Compared with non-sarcopenic patients,sarcopenic patients had lower BMI （MD=-2.48,95%CI：-3.36^-1.60,P〈0.000 01）,VC% （MD=-5.88,95%CI：-8.76^-3.00,P〈0.000 1） and FEV1.0% （MD=-3.33,95%CI：-5.89^-0.77,P=0.01） before operation,but more pulmonary complications （RR=1.77,95%CI：1.10~2.84,P=0.02） and anastomotic leakage （RR=1.47,95%CI：1.10~1.98,P=0.010） after esophagectomy.Conclusion：The patients with esophageal cancer accompanied with sarcopenia may have a lower pulmonary function and BMI,and the increasing risk of post-operative pulmonary complications and anastomotic leakage.