Comparison of stapled versus handsewn loop ileostomy closure: A meta-analysis
Comparison of stapled versus handsewn loop ileostomy closure: A meta-analysis
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DOI：
10.1007/s11605-007-0435-1
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发表时间：
2008-05-01
影响因子：
3.2
通讯作者：
Dixon, Elijah
中科院分区：
文献类型：
--
作者：
Leung, Terry T. W.;MacLean, Anthony R.;Dixon, Elijah
本研究的目的是比较袢式回肠造口术的吻合器和手动缝合闭合之间的小肠梗阻、吻合口并发症和伤口感染的发生率。在Embase、PubMed和科克伦临床试验数据库中使用检索词“闭合”、“回肠袢造口术”和“吻合器”进行文献检索。对所有摘要进行了审查，以识别相关文章，并手动检索其参考文献以查找其他研究。确定了6篇文章纳入。三位独立的评审员提取了以下数据：小肠梗阻率、吻合口并发症、伤口感染、住院时间和手术时间。使用Stata统计软件进行数据分析。比较吻合器与手动缝合闭合，肠梗阻（相对风险[RR] 0.69，95%置信区间[CI] 0.44 - 1.09）、伤口感染（RR 0.91，95% CI 0.53 - 1.97）或吻合口并发症发生率（RR 1.01，95% CI 0.99 - 1.03）无统计学显著差异。2项研究显示，吻合器固定的股骨柄手术时间更短。住院时间无差异。当前文献表明，吻合器和手工缝合环式回肠造口闭合之间没有统计学显著差异，但在更低的小肠梗阻率和更短的手术时间方面，可能存在有利于吻合器闭合的趋势。
The purpose of this study was to compare the rates of small bowel obstruction, anastomotic complications, and wound infections between stapled and handsewn closures of loop ileostomies. A literature search in Embase, PubMed, and Cochrane Database for Clinical Trials using search terms "closure," "loop ileostomy," and "stapled" was performed. All abstracts were reviewed to identify relevant articles, and their references were hand searched for additional studies. Six articles were identified for inclusion. Three independent reviewers extracted the following data: rates of small bowel obstruction, anastomotic complications, wound infection; length of hospital stay; and operative time. Data analysis was performed using Stata statistical software. Comparing stapled versus hand-sewn closures, there were no statistically significant differences in bowel obstruction (relative risk [RR] 0.69, 95% confidence interval [CI] 0.44 to 1.09), wound infection (RR 0.91, 95% CI 0.53 to 1.97), or anastomotic complication rates (RR 1.01, 95% CI 0.99 to 1.03). Two studies showed shorter operative times favoring stapled anastomoses. No difference was seen in length of stay. Current literature suggests no statistically significant differences between stapled and hand-sewn loop ileostomy closures, but there may be a trend favoring stapled closures with regard to lower small bowel obstruction rates and shorter operative time.