结直肠癌患者术后吻合口瘘风险预测模型的系统评价

Risk prediction model of anastomotic leakage in colorectal cancer patients after operation:a systematic review

目的系统评价结直肠癌患者术后吻合口瘘风险预测模型。方法在中国知网、万方数据库、维普中文期刊全文数据库、中国生物医学文献数据库、PubMed、Embase、Wed of Science、Cochrane Library等中英文数据库中全面检索与结直肠癌术后吻合口瘘风险预测模型的相关研究,检索时限为建库至2021年11月30日。由2名研究者独立筛选文献并提取资料信息,使用预测模型研究的偏倚风险和适用性评估工具进行风险偏倚评估。结果共纳入10项研究,纳入研究的预测模型中出现频次较高的预测因子为性别、肿瘤位置、体重指数、术前白蛋白水平和新辅助治疗,预测模型的受试者工作特征曲线下面积为0.63~0.98。纳入研究的偏倚风险主要由研究类型和数据分析引起。结论结直肠癌术后吻合口瘘风险预测模型研究仍处于发展阶段,未来的研究者可参考本研究归纳的常见预测因子并结合临床实际情况选择恰当的方法开发和验证吻合口瘘预测模型,尽早识别患者吻合口瘘的风险并给予针对性预防措施。

Objective To systematically evaluate the risk prediction model of anastomotic leakage in colorectal cancer patients after surgery.Methods The research related to the risk prediction model of anastomotic leakage after colorectal cancer surgery was comprehensively searched in Chinese and English databases such as China National Knowledge Infrastructure(CNKI),Wanfang Data,VIP,Chinese Biomedical Literature Database,PubMed,Embase,Wed of Science and Cochrane Library.The retrieval time limit was from the establishment of the database to November 30,2021.Two researchers independently screened the article and extracted information,and used the bias risk and applicability assessment tools of the prediction model study to assess the risk bias.Results A total of 10 articles were included.The predictors with high frequency in the prediction model included were gender,tumor location,body mass index,preoperative albumin and new adjuvant therapy.The area under the receiver operator characteristic curve of the prediction model was 0.63 to 0.98.The risk of bias in the included studies was mainly caused by the type of study and data analysis.Conclusions The study on the risk prediction model of anastomotic leakage after colorectal cancer surgery is still in the development stage.Future researchers can refer to the common predictive factors summarized in this study and select appropriate methods to develop and verify the prediction model of anastomotic leakage in combination with clinical practice,so as to identify the risk of anastomotic leakage of patients as early as possible and give targeted preventive measures.