带蒂大网膜包埋术预防食管癌术后并发症的Meta分析

doi:10.3760/cma.j.issn.1673422X.2015.09.007

摘要/Abstract

摘要： 目的评价带蒂大网膜包埋术后食管癌患者的住院时间及并发症的发生率。方法计算机检索PubMed、EMbase、The Cochrane Library、Web of Science、中国生物医学文献数据库、中国期刊全文数据库、万方医药期刊全文数据库和维普中文科技期刊全文数据库，收集应用大网膜包埋术后与患者术后吻合口瘘相关的随机对照试验(RCT)，按照纳入排除标准筛选文献，由2位研究者对符合标准的RCT独立进行资料提取和质量评价后，采用RevMan 5.2软件进行Meta分析。结果共检索出206篇相关文献，最终纳入6个RCT，2 167例患者。Meta分析结果显示在术后吻合口瘘和住院时间方面，大网膜包埋术后患者吻合口瘘发生率（OR=0.19，95%CI为0.09～0.39，Z=4.55，P＜0.000 01）和住院时间（MD=-1.91，95%CI为-2.26～-1.57，Z=10.87，P＜0.000 01）明显低于常规食管胃吻合患者，其差异具有统计学意义。在吻合口狭窄和死亡率方面，大网膜包埋术后患者吻合口狭窄发生率（OR=0.76，95%CI为0.29～2.01，Z=0.55，P=0.58）和死亡率（OR=0.72，95%CI为0.24～2.21,Z=0.57，P=0.57）差异无统计学意义。结论与常规食管胃吻合相比较，带蒂大网膜包埋术可以降低食管癌患者术后吻合口瘘的发生率和住院时间，并且没有增加术后吻合口狭窄的发生率和患者的死亡率。

Abstract: ObjectiveTo evaluate the length of hospital stay and the incidences of complications after omentoplasty with nonomentoplasty for the patients with esophageal cancer. MethodsThe databases including Pubmed, Embase, The Cochrane Library, Web of Science, CBM, CNKI, VIP and Wanfang data were searched for collecting randomized controlled trials on the omentoplasty. According to the inclusive and exclusive criteria, the datas were extracted. Two reviewers independently screened literatures and assessed the qualities of the included studies and extracted data. Metaanalysis was performed by using of RevMan 5.2 software. ResultsA total of 6 RCTs including 2 167 patients from 206 original articles were included in this analysis. In terms of the anastomotic leakage after esophagectomy and the hospital stays, the incidence of anastomotic leakage (OR=0.19, 95%CI: 0.09～0.39, Z=4.55, P＜0.000 01) and hospital stays (MD=-1.91, 95%CI:-2.26-1.57, Z=10.87, P＜0.000 01) with omentoplasty was significantly lower than those of the nonomentoplasty, with significant differences. However, in terms of anastomotic stricture (OR=0.76，95%CI: 0.292.01, Z=0.55, P=0.58) and mortality rate (OR=0.72, 95%CI: 0.242.21, Z=0.57, P=0.57), there wrer no significant differences. ConclusionComparing with nonomentoplasty, the use of omentoplasty has beneficial effects for the postoperative complication such as anastomotic leakage and hospital stays, and does not increase the incidence of anastomotic stricture and mortality rate.

蔺瑞江, 胡文滕, 马敏杰, 魏宁, 韩彪. 带蒂大网膜包埋术预防食管癌术后并发症的Meta分析[J]. 国际肿瘤学杂志, 2015, 42(8): 666-.

LIN Rui-Jiang, HU Wen-Teng, MA Min-Jie, WEI Ning, HAN Biao. The use of omentoplasty after esophagectomy for esophageal cancer preventing complications: a metaanalysis[J]. Journal of International Oncology, 2015, 42(8): 666-.

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