Si Chengshuai, Zhang Yunpeng, Sun Peng
Department of General Surgery, Shanghai Huashan Hospital, Fudan University , Shanghai , China.
Scand J Gastroenterol. 2013 Dec;48(12):1428-35. doi: 10.3109/00365521.2013.845905. Epub 2013 Oct 16.
OBJECTIVE. There is no consensus regarding reconstruction type after anterior resection for rectal cancer. We conducted a meta-analysis of relevant randomized controlled trials (RCTs) to compare outcomes of colonic J-pouch (CJlP) and side-to-end anastomosis (STEA) after anterior resection of rectal cancer. METHODS. Electronic databases were searched in January 2013, with six RCTs selected for further analysis, for a total of 451 patients (229 CJP, 222STEA). Outcome measures included surgical, physiologic, and functional outcomes, as well as postoperative complications. The odds ratio (OR) was used in the statistical analysis; in other circumstances, qualitative descriptions were performed. RESULTS. As far as surgical outcomes and postoperative complications, there was no difference between groups. While functional outcomes were substantially impaired, this was similar between groups. CJP demonstrated better function in the early postoperative period. No difference was seen between groups with regards to physiologic outcome. CONCLUSION. CJP and STEA are comparable when choosing the type of reconstruction for restoration of bowel continuity in anterior resection for rectal cancer.
目的。 对于直肠癌前切除术后的重建类型尚无共识。我们对相关随机对照试验(RCT)进行了荟萃分析,以比较直肠癌前切除术后结肠J形贮袋(CJlP)和端侧吻合术(STEA)的结果。方法。 于2013年1月检索电子数据库,选择6项RCT进行进一步分析,共451例患者(229例CJlP,222例STEA)。结局指标包括手术、生理和功能结局以及术后并发症。统计分析采用比值比(OR);在其他情况下,进行定性描述。结果。 就手术结局和术后并发症而言,两组之间无差异。虽然功能结局受到严重损害,但两组相似。CJlP在术后早期表现出更好的功能。两组在生理结局方面未见差异。结论。 在为直肠癌前切除术中恢复肠道连续性选择重建类型时,CJlP和STEA具有可比性。