Effect of antecolic or retrocolic route of gastroenteric anastomosis on delayed gastric emptying after pancreaticoduodenectomy: A meta analysis of randomized controlled trials
Effect of antecolic or retrocolic route of gastroenteric anastomosis on delayed gastric emptying after pancreaticoduodenectomy: A meta analysis of randomized controlled trials
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DOI：
10.1016/j.pan.2015.11.003
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发表时间：
2016-01-01
期刊：
影响因子：
3.6
通讯作者：
Miao, Yi
中科院分区：
文献类型：
--
作者：
Qian, Dong;Lu, Zipeng;Miao, Yi
背景资料：胃排空延迟（DGE）是经典胰十二指肠切除术（PD）或保留幽门PD后最棘手的并发症之一。胃肠道重建的路径是否对DGE有影响仍存在争议。本研究的目的是探讨不同类型的胃肠吻合对PD/PPPD后DGE的影响。方法：系统检索文献数据库（科克伦图书馆，PubMed，EMBASE和Web of Science），以确定合格的研究。利用科克伦协作组的偏倚风险评估工具评价纳入研究的质量。主要结局为DGE发生率。进一步结局包括死亡率、发病率和其他手术相关事件。随机效应或固定效应models.Results：五个随机对照试验（RCT 5），共包括530例患者被确定并纳入分析。基于这些研究，结肠前和结肠后组之间DGE发生率无差异（相对风险[RR]，0.82; 95%置信区间[CI]，0.51-1.32; P = 0.41）。死亡率，发病率和手术相关事件组之间没有显着差异。结论：荟萃分析的结果显示，DGE的发生是不受胃肠吻合的路线。应根据外科医生的偏好选择吻合途径。版权所有（C）2015，IAP和EPC。由爱思唯尔印度出版，里德爱思唯尔印度私人有限公司的一个部门。保留所有权利。
Background: Delayed gastric emptying (DGE) is one of the most troublesome complications after classical pancreaticoduodenectomy (PD) or pylorus-preserving PD. Whether the route of gastroenteric reconstruction has any influence on DGE remains controversial. The aim of this study was to investigate the influence of different types of gastroenteric anastomosis on DGE after PD/PPPD.Methods: A systematic search of literature databases (Cochrane Library, PubMed, EMBASE, and Web of Science) was performed to identify eligible studies. Cochrane collaboration's tool for assessing risk of bias was utilized to evaluate the quality of included studies. The primary outcome was DGE incidence rate. Further outcomes included mortality, morbidity, and other operation related events. Random-effect or fix-effect models were used as appropriate.Results: Five randomized controlled trials (RCT5) including a total of 530 patients were identified and included in the analysis. Based on these studies, no difference was found in DGE incidence between antecolic and retrocolic groups (relative risk [RR], 0.82; 95% confidence interval [CI], 0.51-1.32; P = 0.41). Mortality, morbidity, and operation related events were not significantly different between groups.Conclusions: Results of the meta-analysis reveal that DGE occurrence is not affected by route of gastroenteric anastomosis. Anastomosis approach should be chosen according to the surgeons' preference. Copyright (C) 2015, IAP and EPC. Published by Elsevier India, a division of Reed Elsevier India Pvt. Ltd. All rights reserved.