Department of General Surgery, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China.
Operating Theater and Department of Anesthesiology, The Second Hospital of Jilin University, Changchun, 130041, Jilin, China.
World J Surg Oncol. 2021 Nov 4;19(1):318. doi: 10.1186/s12957-021-02432-x.
Protective ileostomy is always applied to avoid clinically significant anastomotic leakage and other postoperative complications for patients receiving laparoscopic rectal cancer surgery. However, whether it is necessary to perform the ileostomy is still controversial. This meta-analysis aims to analyze the efficacy of ileostomy on laparoscopic rectal cancer surgery.
Cochrane Library, EMBASE, Web of Science, and PubMed were applied for systematic search of all relevant literature, updated to May 07, 2021. Studies compared patients with and without ileostomy for laparoscopic rectal cancer surgery. We applied Review Manager software to perform this meta-analysis. The quality of the non-randomized controlled trials was assessed using the Newcastle-Ottawa scale (NOS), and the randomized studies were assessed using the Jadad scale.
We collected a total of 1203 references, and seven studies were included using the research methods. The clinically significant anastomotic leakage rate was significantly lower in ileostomy group (27/567, 4.76%) than that in non-ileostomy group (54/525, 10.29%) (RR = 0.47, 95% CI 0.30-0.73, P for overall effect = 0.0009, P for heterogeneity = 0.18, I = 32%). However, the postoperative hospital stay, reoperation, wound infection, and operation time showed no significant difference between the ileostomy and non-ileostomy groups.
The results demonstrated that protective ileostomy could decrease the clinically significant anastomotic leakage rate for patients undergoing laparoscopic rectal cancer surgery. However, ileostomy has no effect on postoperative hospital stay, reoperation, wound infection, and operation time. The efficacy of ileostomy after laparoscopic rectal cancer surgery: a meta-analysis.
保护性回肠造口术常用于避免接受腹腔镜直肠癌手术的患者出现临床显著的吻合口漏和其他术后并发症。然而，是否需要进行回肠造口术仍存在争议。本荟萃分析旨在分析回肠造口术对腹腔镜直肠癌手术的疗效。
系统检索了 Cochrane Library、EMBASE、Web of Science 和 PubMed 中所有相关文献，更新至 2021 年 5 月 07 日。研究比较了接受腹腔镜直肠癌手术的有和无回肠造口术的患者。使用 Review Manager 软件进行荟萃分析。采用纽卡斯尔-渥太华量表（NOS）评估非随机对照试验的质量，采用 Jadad 量表评估随机研究。
共收集了 1203 篇参考文献，采用研究方法纳入了 7 项研究。回肠造口术组（27/567，4.76%）的临床显著吻合口漏发生率明显低于非回肠造口术组（54/525，10.29%）（RR=0.47，95%CI 0.30-0.73，P 总效应=0.0009，P 异质性=0.18，I²=32%）。然而，回肠造口术组和非回肠造口术组的术后住院时间、再次手术、伤口感染和手术时间无显著差异。
结果表明，保护性回肠造口术可降低接受腹腔镜直肠癌手术患者的临床显著吻合口漏发生率。然而，回肠造口术对术后住院时间、再次手术、伤口感染和手术时间无影响。腹腔镜直肠癌手术后回肠造口术的疗效：荟萃分析。
