Department of Gastrointestinal Surgery, Affiliated Hospital of Hebei University, Hebei, China.
Int Wound J. 2023 Jan;20(1):164-172. doi: 10.1111/iwj.13860. Epub 2022 Jun 7.
We performed a meta-analysis to evaluate the effect of body mass index on surgical site wound infection, mortality, and postoperative hospital stay in subjects undergoing possibly curative surgery for colorectal cancer. A systematic literature search up to March 2022 was performed and 2247 subjects with possibly curative surgery for colorectal cancer at the baseline of the studies; 2889 of them were obese, and 9358 were non-obese. Odds ratio (OR) and mean difference (MD) with 95% confidence intervals (CIs) were calculated to assess the effect of body mass index on surgical site wound infection, mortality, and postoperative hospital stay in subjects undergoing possibly curative surgery for colorectal cancer using the dichotomous or contentious methods with a random or fixed-effect model. The obese subjects had a significantly higher surgical site wound infection after colorectal surgery (OR, 1.87; 95% CI, 1.62-2.15, P < .001), and higher mortality (OR, 1.58; 95% CI, 1.07-2.32, P = .02) in subjects with possibly curative surgery for colorectal cancer compared with non-obese. However, obese did not show any significant difference in postoperative hospital stay (MD, 0.81; 95% CI, -0.030 to 1.92, P = .15) compared with non-obese in subjects with possibly curative surgery for colorectal cancer. The obese subjects had a significantly higher surgical site wound infection after colorectal surgery, higher mortality, and no significant difference in postoperative hospital stay compared with non-obese in subjects with possibly curative surgery for colorectal cancer. The analysis of outcomes should be with caution because of the low number of studies in certain comparisons.
我们进行了一项荟萃分析,以评估体重指数对接受结直肠癌症根治性手术的患者的手术部位感染、死亡率和术后住院时间的影响。系统检索截至 2022 年 3 月的文献,并对研究基线时的 2247 例接受结直肠癌症根治性手术的患者进行了分析;其中 2889 例肥胖,9358 例非肥胖。使用二分类或连续变量方法,采用随机或固定效应模型,计算比值比(OR)和均数差(MD)及其 95%置信区间(CI),以评估体重指数对接受结直肠癌症根治性手术患者的手术部位感染、死亡率和术后住院时间的影响。与非肥胖患者相比,肥胖患者结直肠手术后手术部位感染(OR,1.87;95%CI,1.62-2.15,P < .001)和死亡率(OR,1.58;95%CI,1.07-2.32,P = .02)更高。然而,在接受结直肠癌症根治性手术的患者中,肥胖与非肥胖患者相比,术后住院时间无显著差异(MD,0.81;95%CI,-0.030 至 1.92,P = .15)。与非肥胖患者相比,肥胖患者结直肠手术后手术部位感染更高、死亡率更高,但术后住院时间无显著差异。由于某些比较的研究数量较少,因此对结果的分析应谨慎。