Cong Zhi-jie, Hu Liang-hao, Xing Jun-jie, Bian Zheng-qian, Fu Chuan-gang, Yu En-da, Li Zhao-shen, Zhong Ming
1 Colorectal Team, Department of General Surgery, Ren Ji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China.
Int Surg. 2014 Mar-Apr;99(2):112-9. doi: 10.9738/INTSURG-D-13-00059.
Anastomotic dehiscence (AD) requiring reoperation is the most severe complication following anterior rectal resection. We performed a systematic review on studies that describe AD requiring reoperation and its subsequent mortality after anterior resection for rectal carcinoma. A systematic search was performed on published literature. Data on the definition and rate of AD, the number of ADs requiring reoperation, the mortality caused by AD, and the overall postoperative mortality were pooled and analyzed. A total of 39 studies with 24,232 patients were analyzed. The studies varied in incidence and definition of AD. Systematic review of the data showed that the overall rate of AD was 8.6%, and the rate of AD requiring reoperation was 5.4%. The postoperative mortality caused by AD was 0.4%, and the overall postoperative mortality was 1.3%. We found considerable risk and mortality for AD requiring reoperation, which largely contributed to the overall postoperative mortality.
需要再次手术的吻合口裂开（AD）是直肠前切除术后最严重的并发症。我们对描述直肠癌前切除术后需要再次手术的AD及其随后死亡率的研究进行了系统评价。对已发表文献进行了系统检索。汇总并分析了关于AD的定义和发生率、需要再次手术的AD数量、AD导致的死亡率以及总体术后死亡率的数据。共分析了39项研究，涉及24232例患者。这些研究在AD的发生率和定义方面存在差异。对数据的系统评价表明，AD的总体发生率为8.6%，需要再次手术的AD发生率为5.4%。AD导致的术后死亡率为0.4%，总体术后死亡率为1.3%。我们发现需要再次手术的AD存在相当大的风险和死亡率，这在很大程度上导致了总体术后死亡率。
