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术中用生理盐水冲洗直肠可有效预防吻合口复发:一项荟萃分析。

Intra-operative rectal washout with saline solution can effectively prevent anastomotic recurrence: a meta-analysis.

作者信息

Zhou Can, Ren Yu, Wang Ke, Liu Jie, He Jian-Jun, Liu Pei-Jun

机构信息

Department of Centre of Translational Medicine, the First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, Shaanxi, China E-mail :

出版信息

Asian Pac J Cancer Prev. 2013;14(12):7155-9. doi: 10.7314/apjcp.2013.14.12.7155.

Abstract

BACKGROUND AND OBJECTIVE

Rectal washout with saline solution may theoretically prevent anastomotic recurrence in patients with resectable rectal cancer, although exact clinical effects have not yet been determined. In order to derive a more precise estimation of the relationship, the present meta-analysis was performed.

METHOD

Relevant studies were identified by a search of Medline, Embase and Google Website with no restrictions to September 1, 2013, and included in the systematic review and meta-analysis.

RESULTS

5 trials (642 participants) were included to assess the association between rectal washout with saline solution and anastomotic recurrence. The rate of anastomotic recurrence (AR) was 6.23% (40/642), with the pooled OR derived from the five studies being 0.32 (95 % CI=0.15-0.70, P=0.004). The pooled OR derived from the TME and radical resection subgroups were 0.72 (95%CI=0.16-3.12, P=0.66) and 0.51 (95%CI=0.13-1.96, P=0.32), respectively.

CONCLUSION

Results from this analysis show that intra-operative rectal washout with mere saline solution largely reduces the risk of anastomotic recurrences in patients with resectable rectal cancer.

摘要

背景与目的

理论上,用盐溶液进行直肠冲洗可预防可切除直肠癌患者的吻合口复发,但其确切临床效果尚未确定。为了更精确地评估这种关系,进行了本荟萃分析。

方法

通过检索Medline、Embase和谷歌网站确定相关研究,检索截至2013年9月1日无限制,纳入系统评价和荟萃分析。

结果

纳入5项试验(642名参与者)以评估用盐溶液进行直肠冲洗与吻合口复发之间的关联。吻合口复发率(AR)为6.23%(40/642),五项研究得出的合并OR为0.32(95%CI = 0.15 - 0.70,P = 0.004)。来自TME和根治性切除亚组的合并OR分别为0.72(95%CI = 0.16 - 3.12,P = 0.66)和0.51(95%CI = 0.13 - 1.96,P = 0.32)。

结论

该分析结果表明,仅用盐溶液进行术中直肠冲洗可大幅降低可切除直肠癌患者吻合口复发的风险。

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