头颈部癌症大手术中的糖尿病：系统评价与荟萃分析。

Diabetes mellitus in major head and neck cancer surgery: Systematic review and meta-analysis.

作者信息

Caputo Mathew P, Shabani Sepehr, Mhaskar Rahul, McMullen Caitlin, Padhya Tapan A, Mifsud Matthew J

机构信息

Department of Otolaryngology-Head & Neck Surgery, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.

Department of Internal Medicine, University of South Florida Morsani College of Medicine, Tampa, Florida, USA.

出版信息

Head Neck. 2020 Oct;42(10):3031-3040. doi: 10.1002/hed.26349. Epub 2020 Jul 11.

DOI:10.1002/hed.26349

PMID:32652771

Abstract

BACKGROUND

Diabetes mellitus (DM) is a risk factor for surgical complications and a common comorbidity in the setting of head and neck (H&N) cancer. Our objective was to determine if DM is associated with increased rates of H&N cancer surgery complications.

METHODS

We conducted a search of Pubmed, Embase, and the national clinical trials database focusing on H&N cancer surgery or free flap reconstruction and diabetes. Two reviewers screened studies by title/abstract and then full text. We then collected data using a pre-made template. Meta-analysis was performed using Revman 5.3.

RESULTS

Of the 272 results from Pubmed and 559 from Embase, we selected 16 studies for inclusion. Meta-analysis revealed DM was associated with increased rates of flap failure (risk ratio [RR] = 1.83 95% confidence interval [CI], 1.18-2.85; P = .007) and local complications (RR = 1.87 95% CI, 1.24-2.80; P < .00001).

CONCLUSION

Although DM is associated with increased risk of flap failure and local H&N cancer surgery complications, further research is required to optimize care in this population.

摘要

背景

糖尿病（DM）是手术并发症的危险因素，也是头颈（H&N）癌患者中常见的合并症。我们的目的是确定糖尿病是否与头颈癌手术并发症发生率增加有关。

方法

我们检索了PubMed、Embase和国家临床试验数据库，重点关注头颈癌手术或游离皮瓣重建与糖尿病。两名评审员先通过标题/摘要筛选研究，然后进行全文筛选。接着我们使用预先制作的模板收集数据。使用Revman 5.3进行荟萃分析。

结果

在PubMed检索出的272项结果和Embase检索出的559项结果中，我们选择了16项研究纳入分析。荟萃分析显示，糖尿病与皮瓣失败率增加（风险比[RR]=1.83，95%置信区间[CI]为1.18 - 2.85；P = 0.007）和局部并发症（RR = 1.87，95% CI为1.24 - 2.80；P < 0.00001）相关。