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直肠阴道瘘转流造口的效果:一项系统评价与荟萃分析方案

Effect of diverting stoma for rectovaginal fistula: A protocol of systematic review and meta-analysis.

作者信息

Fu Wenqiang, Yi Sibin, An Mingwei, Tang Yong, Tang Luwei, Wang Yanru, Yuan Yishun, Zhou Qiong, Hu Yanfang, Wen Yiqi

机构信息

Jiangxi University of Traditional Chinese Medicine.

The Affiliated Hospital of Jiangxi University of Traditional Chinese Medicine, Nanchang, P.R. China.

出版信息

Medicine (Baltimore). 2020 Dec 4;99(49):e23202. doi: 10.1097/MD.0000000000023202.

Abstract

BACKGROUND

Rectovaginal fistula (RVF) is a pathologic channel between the anterior wall of the rectum and the posterior wall of the vagina, is rare, and the majority is of traumatic origin. The most common causes are obstetric trauma, local infection, rectal surgery or caused by chronic inflammatory bowel disease. Once the disease will seriously affect the patient's quality of life, and generally not self-healing, most require surgical intervention. At present, diverting stoma is mainly used in patients with severe RVF or complicated RVF or patients with Crohn disease. Due to the lack of large sample, linical studies, its clinical effectiveness is still controversial. The purpose of this systematic review is to evaluate the efficacy of diverting stoma in the treatment of diverting stoma.

METHODS

EMBASE, PubMed, the Cochrane Library, Chinese National Knowledge Infrastructure (CNKI), Wanfang Database, Chinese Biomedical Literature Database (CBM), and Chinese VIP Information will be searched systematically by 2 reviewers from the inception until October 2020. The original study that randomized controlled trials (RCTs), clinical controlled trials (CCTs), nonrandomized control trials (NCTs), and retrospective trials (RTs) of diverting stoma for RVF will be selected. In addition, similar searches will be conducted for the reference lists, researches in progress, and the citation lists of identified publications. Study selection, data extraction, and assessment of the quality will be performed independently by 2 reviewers who have been trained prior to data extraction. A meta-analysis will be conduct if the quantity and quality of the original studies included are satisfactory; otherwise, a descriptive analysis will be conducted. Review Manager 5.4 software (The Nordic Cochrane Centre, The Cochrane Collaboration, Copenhagen, Denmark) will be using for data synthesis and assessment the risk of bias according by Cochrane Handbook.

RESULT

This study will provide a comprehensive review of current evidence for the treatment of diverting stoma on RVF.

CONCLUSION

The conclusion of this study will provide a judging basis that whether the treatment of RVF with diverting stoma is effective.

INPLASY REGISTRATION NUMBER

INPLASY2020090070.

摘要

背景

直肠阴道瘘(RVF)是直肠前壁与阴道后壁之间的病理性通道,较为罕见,多数由外伤引起。最常见的病因是产科创伤、局部感染、直肠手术或慢性炎症性肠病。一旦患病会严重影响患者生活质量,且一般不会自愈,多数需要手术干预。目前,转流造口主要用于重度RVF或复杂性RVF患者或克罗恩病患者。由于缺乏大样本临床研究,其临床疗效仍存在争议。本系统评价旨在评估转流造口治疗RVF的疗效。

方法

两名评价者将从建库至2020年10月对EMBASE、PubMed、Cochrane图书馆、中国知网(CNKI)、万方数据库、中国生物医学文献数据库(CBM)和中文维普资讯进行系统检索。将选取关于RVF转流造口的随机对照试验(RCT)、临床对照试验(CCT)、非随机对照试验(NCT)和回顾性试验(RT)的原始研究。此外,将对纳入文献的参考文献列表、正在进行的研究以及已发表文献的被引列表进行类似检索。由两名在数据提取前经过培训的评价者独立进行研究选择、数据提取和质量评估。如果纳入的原始研究数量和质量令人满意,将进行Meta分析;否则,将进行描述性分析。将使用Review Manager 5.4软件(北欧Cochrane中心,Cochrane协作网,丹麦哥本哈根)进行数据合成,并根据Cochrane手册评估偏倚风险。

结果

本研究将全面综述目前关于转流造口治疗RVF的证据。

结论

本研究结论将为判断转流造口治疗RVF是否有效提供依据。

INPLASY注册号:INPLASY2020090070。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b490/7717780/7201a30c6b33/medi-99-e23202-g001.jpg

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