Ha Gi Won, Lee Min Ro, Kim Jong Hun
Research Institute of Clinical Medicine, Chonbuk National University Medical School, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, South Korea.
Research Institute of Clinical Medicine, Chonbuk National University Medical School, San 2-20 Geumam-dong, Deokjin-gu, Jeonju, Jeonbuk 561-180, South Korea.
Am J Surg. 2016 Sep;212(3):527-36. doi: 10.1016/j.amjsurg.2016.02.019. Epub 2016 May 10.
It is considered that laparoscopic surgery is associated with a much lower rate of postoperative formation of adhesions than open surgery. This meta-analysis assessed the incidence of adhesion-related readmissions and surgery for adhesive small bowel obstruction (SBO) in patients who underwent laparoscopic or open colorectal surgery.
Multiple comprehensive databases were searched systematically to identify relevant studies and meta-analysis was done.
Meta-analysis showed that laparoscopic surgery was associated with a lower rate of adhesive SBO, both for randomized clinical trials (relative risk [RR] .26, 95% confidence interval [CI] .10 to .67, I(2)=41%) and nonrandomized studies (RR .49, 95% CI .32 to .76, I(2)=91%). Laparoscopic surgery was also associated with a lower rate of subsequent surgery for adhesive SBO, both for randomized clinical trials (RR .25, 95% CI .06 to .96, I(2)=0%) and nonrandomized studies (RR .56, 95% CI .33 to .94, I(2)=77%).
Laparoscopic colorectal surgery significantly reduced the rates of adhesive SBO and subsequent surgery for adhesive SBO, compared with open surgery.
人们认为，与开放手术相比，腹腔镜手术术后粘连形成率要低得多。本荟萃分析评估了接受腹腔镜或开放结直肠手术的患者因粘连性小肠梗阻（SBO）再次入院及手术的发生率。
系统检索多个综合数据库以识别相关研究并进行荟萃分析。
荟萃分析表明，无论是随机临床试验（相对危险度[RR]0.26，95%置信区间[CI]0.10至0.67，I² = 41%）还是非随机研究（RR 0.49，95% CI 0.32至0.76，I² = 91%），腹腔镜手术与粘连性SBO发生率较低相关。对于粘连性SBO的后续手术率，腹腔镜手术同样与之较低相关，无论是随机临床试验（RR 0.25，95% CI 0.06至0.96，I² = 0%）还是非随机研究（RR 0.56，95% CI 0.33至0.94，I² = 77%）。
与开放手术相比，腹腔镜结直肠手术显著降低了粘连性SBO及粘连性SBO后续手术的发生率。
