Postoperative outcomes following mechanical bowel preparation before proctectomy: a meta-analysis
Postoperative outcomes following mechanical bowel preparation before proctectomy: a meta-analysis
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DOI：
10.1111/codi.13026
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发表时间：
2015-10-01
影响因子：
3.4
通讯作者：
Winter, D. C.
中科院分区：
文献类型：
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作者：
Courtney, D. E.;Kelly, M. E.;Winter, D. C.
目的以往关于结直肠手术前机械性肠道准备(MBP)的Meta分析将结肠和直肠切除归为一组。在直肠切除术后没有MBP的情况下，术后发病率会增加。本研究使用荟萃分析技术评估直肠切除前接受MBP治疗的患者的比较结果。方法对已发表的关于直肠切除前接受MBP治疗对患者预后影响的研究进行全面检索。结果共纳入11项研究，1258例患者。总的并发症发生率(OR 1.062，95%CI 0.584~1.933，P=0.844)、吻合口漏(OR 1.144，95%CI 0.767~1.708，P=0.509)、手术部位感染(OR 0.946，95%CI 0.549~1.498，P=0.812)和死亡率(OR 1.377，95%CI 0.549~3.455，P=0.85)无显著差异。P=0.495)。结论目前的研究没有显示出在直肠切除术前使用MBP的益处，但数据是有限的。关于其使用的决定应在个案基础上作出。
Aim Previous meta-analyses of mechanical bowel preparation (MBP) before colorectal surgery have grouped colon and rectal resection together. An increased postoperative morbidity has been suggested in the absence of MBP following proctectomy. The current study used meta-analytical techniques to evaluate the comparative outcome of patients who received MBP prior to proctectomy.Method A comprehensive search was performed for published studies examining the effect of MBP before proctectomy on patient outcome. Random effects methods were used to combine data.Results Eleven studies including 1258 patients were identified. There was no significant difference in overall morbidity (OR 1.062, 95% CI 0.584-1.933, P = 0.844), anastomotic leakage (OR 1.144, 95% CI 0.767-1.708, P = 0.509), surgical site infection (OR 0.946, 95% CI 0.549-1.498, P = 0.812) or mortality (OR 1.377, 95% CI 0.549-3.455, P = 0.495) between those who did not and those who did receive MBP prior to proctectomy.Conclusion The current study did not demonstrate a beneficial effect of MBP prior to proctectomy, but the data were limited. Decision-making as to its use should be made on a case-by-case basis.