Meta-analysis: effect of preoperative infliximab use on early postoperative complications in patients with ulcerative colitis undergoing abdominal surgery
Meta-analysis: effect of preoperative infliximab use on early postoperative complications in patients with ulcerative colitis undergoing abdominal surgery
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Meta分析：术前使用英夫利昔单抗对溃疡性结肠炎腹部手术患者术后早期并发症的影响
DOI：
10.1111/apt.12060
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发表时间：
2012-11-01
影响因子：
7.6
通讯作者：
Fan, D.
中科院分区：
文献类型：
--
作者：
Yang, Z.;Wu, Q.;Fan, D.
背景英夫利西单抗广泛应用于重度和难治性溃疡性结肠炎（UC）。关于术前使用英夫利西单抗是否会增加UC患者术后早期并发症的临床研究结果不一致。目的确定UC患者腹部手术后术前英夫利西单抗治疗的临床安全性和有效性。方法检索PubMed、Embase数据库中比较术前接受英夫利西单抗与未接受英夫利西单抗的UC患者术后发病率的对照观察性研究。主要终点为总并发症发生率。次要终点包括感染和非感染并发症的发生率。我们计算了合并比值比（OR）和95%置信区间（CI）作为汇总指标。结果共纳入13篇文献，涉及2933例患者。术前英夫利西单抗治疗与术后总并发症（OR=1.09，95%CI：0.871.37，P=0.47）、感染性并发症（OR=1.10，95%CI：0.512.38，P=0.81）和非感染性并发症（OR=1.10，95%CI：0.761.59，P=0.61）无显著相关性。术前12周内使用英夫利西单抗可能是预防感染的保护因素（OR=0.43，95%CI：0.220.83，P=0.01）。结论术前使用英夫利西单抗不会增加溃疡性结肠炎患者腹部手术后早期并发症的风险。
Background Infliximab is widely used in severe and refractory ulcerative colitis (UC). The results of clinical studies are inconsistent on whether preoperative infliximab use increases early postoperative complications in UC patients. Aim To determine the clinical safety and efficacy of preoperative infliximab treatment in UC patients with regard to short-term outcomes following abdominal surgery. Methods PubMed, Embase databases were searched for controlled observational studies comparing postsurgical morbidity in UC patients receiving infliximab preoperatively with those not on infliximab. The primary endpoint was total complication rate. Secondary endpoints included the rate of infectious and non-infectious complications. We calculated pooled odds ratios (ORs) with 95% confidence intervals (CIs) as summary measures. Results A total of 13 studies involving 2933 patients were included in our meta-analysis. There was no significant association between infliximab therapy preoperatively and total (OR=1.09, 95% CI: 0.871.37, P=0.47), infectious (OR=1.10, 95% CI: 0.512.38, P=0.81) and non-infectious (OR=1.10, 95% CI: 0.761.59, P=0.61) postoperative complications respectively. Infliximab might be a protective factor against infection for the use within 12weeks prior to surgery (OR=0.43, 95% CI: 0.220.83, P=0.01). No publication bias was found. Conclusion Preoperative infliximab use does not increase the risk of early postoperative complications in patients with ulcerative colitis undergoing abdominal surgery.