Human Nutrition, School of Medicine, Dentistry and Nursing, College of Medical, Veterinary and Life of Sciences, University of Glasgow, Glasgow Royal Infirmary, Glasgow, G312ER, United Kingdom.
Academic Unit of Surgery, College of Medical, Veterinary and Life of Sciences- University of Glasgow, Royal Infirmary, Glasgow, G312ER, United Kingdom.
Crit Rev Oncol Hematol. 2018 Jan;121:68-73. doi: 10.1016/j.critrevonc.2017.12.004. Epub 2017 Dec 7.
The prevalence of obesity has increased worldwide over the last few decades, and is a well-recognized risk factor for colorectal cancer. Surgical site infection is the most frequent complication following surgery for colorectal cancer, and the main cause of postoperative morbidity. The aim of the present systematic review and meta-analysis was to examine the relationship between increasing BMI and postoperative surgical site infection following surgery for colorectal cancer.
A systemic literature search was conducted using Medline, PubMed, Embase (Ovid) and Web of Science databases from inception to the end of August 2016. Studies examining the relationship between obesity and surgical site infection following surgery for colorectal cancer were included. Analysis of the data was performed using Review Manager version 5.3(The Nordic Cochrane Centre, The Cochrane Collaboration, Copen-hagen, Denmark,) RESULTS: In this meta-analysis, a total of 9535 patients from 16 studies were included. BMI <30 vs ≥30kg/m was used to examine the association of obesity and surgical site infection in patients from Western countries. The estimated pooled OR demonstrated that obesity increased the risk of surgical site infection by approximately 100% (OR=2.13; 95% CI 1.66-2.72, p<0.001).BMI <25 vs ≥25kg/m was used to examine the association of obesity and surgical site infection from Asian countries. The estimated pooled OR demonstrated that obesity increased the risk of surgical site infection by approximately 60% (OR=1.63; 95% CI 1.29-2.06, p<0.001). There was little evidence of publication bias in the meta-analysis.
From this systematic review and meta-analysis there was good evidence that obesity was associated with a significantly higher risk of developing surgical site infection following surgery for colorectal cancer in both ethnic groups. The magnitude of the effect warrants further investigation.
在过去几十年中，全球肥胖患病率有所增加，肥胖是结直肠癌的公认危险因素。手术部位感染是结直肠癌手术后最常见的并发症，也是术后发病率的主要原因。本系统评价和荟萃分析的目的是研究 BMI 增加与结直肠癌手术后手术部位感染之间的关系。
使用 Medline、PubMed、Embase（Ovid）和 Web of Science 数据库从建库到 2016 年 8 月底进行了系统文献检索。纳入研究肥胖与结直肠癌手术后手术部位感染之间关系的研究。使用 Review Manager 版本 5.3（北欧 Cochrane 中心，Cochrane 协作组织，丹麦哥本哈根）进行数据分析。
在这项荟萃分析中，共纳入了 16 项研究中的 9535 名患者。BMI<30 与 BMI≥30kg/m 用于检查西方国家患者肥胖与手术部位感染的相关性。估计的合并 OR 表明，肥胖使手术部位感染的风险增加了约 100%（OR=2.13；95%CI 1.66-2.72，p<0.001）。BMI<25 与 BMI≥25kg/m 用于检查亚洲国家患者肥胖与手术部位感染的相关性。估计的合并 OR 表明，肥胖使手术部位感染的风险增加了约 60%（OR=1.63；95%CI 1.29-2.06，p<0.001）。荟萃分析中几乎没有证据表明存在发表偏倚。
从这项系统评价和荟萃分析中可以得出很好的证据，即肥胖与结直肠癌手术后手术部位感染的风险显著增加有关，在两个种族群体中都是如此。这种影响的程度值得进一步调查。
