肝切除术后围手术期输血对结直肠癌肝转移患者临床结局的影响：一项荟萃分析

Impact of perioperative blood transfusion on clinical outcomes in patients with colorectal liver metastasis after hepatectomy: a meta-analysis.

作者信息

Lyu Xinghua, Qiao Wenhui, Li Debang, Leng Yufang

机构信息

Department of Anaesthesiology, The First Hospital of Lanzhou University, Lanzhou, China.

出版信息

Oncotarget. 2017 Jun 20;8(25):41740-41748. doi: 10.18632/oncotarget.16771.

BACKGROUND

Perioperative blood transfusion may be associated with negative clinical outcomes in oncological surgery. A meta-analysis of published studies was conducted to evaluate the impact of blood transfusion on short- and long-term outcomes following liver resection of colorectal liver metastasis (CLM).

MATERIALS AND METHODS

A systematic search was performed to identify relevant articles. Data were pooled for meta-analysis using Review Manager version 5.3.

RESULTS

Twenty-five observational studies containing 10621 patients were subjected to the analysis. Compared with non-transfused patients, transfused patients experienced higher overall morbidity (odds ratio [OR], 1.98; 95% confidence intervals [CI] =1.49-2.33), more major complications (OR, 2.12; 95% CI =1.26-3.58), higher mortality (OR, 4.13; 95% CI =1.96-8.72), and longer length of hospital stay (weighted mean difference, 4.43; 95% CI =1.15-7.69). Transfusion was associated with reduced overall survival (risk ratio [RR], 1.24, 95% CI =1.11-1.38) and disease-free survival (RR, 1.38, 95% CI=1.23-1.56).

CONCLUSION

Perioperative blood transfusion has a detrimental impact on the clinical outcomes of patients undergoing CLM resection.

背景

围手术期输血可能与肿瘤手术的不良临床结局相关。我们对已发表的研究进行了一项荟萃分析，以评估输血对结直肠癌肝转移（CLM）肝切除术后短期和长期结局的影响。

材料与方法

进行系统检索以识别相关文章。使用Review Manager 5.3版对数据进行汇总以进行荟萃分析。

结果

对25项包含10621例患者的观察性研究进行了分析。与未输血患者相比，输血患者的总体发病率更高（优势比[OR]，1.98；95%置信区间[CI]=1.49-2.33），主要并发症更多（OR，2.12；95%CI=1.26-3.58），死亡率更高（OR，4.13；95%CI=1.96-8.72），住院时间更长（加权平均差，4.43；95%CI=1.15-7.69）。输血与总生存期降低（风险比[RR]，1.24，95%CI=1.11-1.38）和无病生存期降低（RR，1.38，95%CI=1.23-1.56）相关。