胃癌术后吻合口瘘影响因素的Meta分析

Meta-analysis of risk factors for anastomotic fistula after gastric cancer surgery

目的 探讨胃癌术后吻合口瘘发生的影响因素。方法 检索中国知识基础设施工程、中国生物医学文献数据库、万方数据库、维普数据库、PubMed、Web of Science、Embase、The Cochrane Library中有关胃癌术后吻合口瘘影响因素的研究,检索时限均从建库至2022年11月。采用RevMan 5.3软件进行Meta分析。结果 术前糖尿病(OR=2.82,95%CI:[1.19,6.68])、肺功能不全(OR=2.10,95%CI:[1.28,3.46])、消化道梗阻(OR=2.89,95%CI:[1.22,6.84])、消化道重建方式(OR=5.69,95%CI:[2.16,14.97])、围手术期输血(OR=2.52,95%CI:[1.63,3.91])是胃癌术后吻合口瘘发生的危险因素;吻合器吻合(OR=0.45,95%CI:[0.29,0.71])、TNM分期为Ⅰ-Ⅱ期(OR=0.67,95%CI:[0.51,0.89])是胃癌术后吻合口瘘发生的保护因素。结论 通过Meta分析胃癌术后吻合口瘘的影响因素,早期干预有助于降低患者术后吻合口瘘的发生率。

Objective To investigate the influencing factors of anastomotic fistula after gastric cancer surgery.Methods Studies on the influencing factors of anastomotic fistula after gastric cancer surgery were searched for in the Chinese National Knowledge Infrastructure,China Biology Medicine Disc,Wanfang datebase,VIP datebase,PubMed,Web of Science,Embase and The Cochrane Library from the establishment of the databases to November 2022.A Meta-analysis was performed using Revman 5.3 software.Results Preoperative diabetes mellitus(OR=2.82,95%CI:[1.19,6.68]),preoperative pulmonary insufficiency(OR=2.10,95%CI:[1.28,3.46]),gastrointestinal obstruction(OR=2.89,95%CI:[1.22,6.84]),GI reconstruction(OR=5.69,95%CI:[2.16,14.97])and perioperative blood transfusion(OR=2.52,95%CI:[1.63,3.91])were found to be the risk factors for anastomotic fistula after gastric cancer surgery.Anastomosis(OR=0.45,95%CI:[0.29,0.71])and TNM stage(OR=0.67,95%CI:[0.51,0.89])were protective factors for the occurrence of anastomotic fistula after gastric cancer surgery.Conclusion The Meta-analysis of the influencing factors of postoperative anastomotic fistula in gastric cancer and early intervention can help reduce the incidence of postoperative anastomotic fistula.