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维生素E作为腹膜/腹腔粘连预防措施的系统评价和荟萃分析。

Vitamin E administration as preventive measures for peritoneal/intra-abdominal adhesions: A systematic review and meta-analysis.

作者信息

Sudirman Taufik, Hatta Mochammad, Prihantono Prihantono, Bukhari Agussalim, Tedjasaputra Tjahyadi Robert, Lie Hendry

机构信息

Department of Surgery, Faculty of Medicine, Pelita Harapan University, Tangerang, Indonesia.

Department of Molecular Biology and Immunology for Infectious Disease, Faculty of Medicine, Universitas Hasanuddin, Makassar, Indonesia.

出版信息

Ann Med Surg (Lond). 2022 Jul 31;80:104225. doi: 10.1016/j.amsu.2022.104225. eCollection 2022 Aug.

Abstract

BACKGROUND

Peritoneal adhesion still becoming a common complication after abdominal surgeries and become a significant threat to digestive surgeons nowadays. Vitamin E might offer benefits for preventing peritoneal adhesions because of its antioxidant, anti-inflammatory, and anti-fibroblastic properties. This study sought to analyze the relationship between vitamin E administration and peritoneal/intra-abdominal adhesions in rat models.

METHODS

Potential articles were searched by using specific keywords on Scopus, PubMed, PMC, and Cochrane Library databases until March 12th, 2022. All published studies on vitamin E and peritoneal/abdominal adhesions in rat models were collected. Statistical analysis was performed by using Review Manager 5.4 software.

RESULTS

A total of 9 studies were included in the final analysis. Pooled analysis of the evidences yielded an association between vitamin E and decreased incidence of substantial peritoneal/intra-abdominal adhesions (RR 0.46; 95%CI: 0.33-0.64,  < 0.00001,  = 61%, random-effect modeling); and reduction in the mean grade of adhesions (Mean Difference -1.53; 95%CI: -2.00, -1.06,  < 0.00001,  = 98%, random-effect modeling).

CONCLUSIONS

This study proposes that vitamin E supplementation might offer benefits in the prevention of peritoneal/intra-abdominal adhesions. More in-vivo studies with larger sample sizes and proper methods are still needed to confirm the results of our study. If possible, studies on humans might also be warranted.

摘要

背景

腹膜粘连仍是腹部手术后常见的并发症,如今对消化外科医生构成重大威胁。维生素E因其抗氧化、抗炎和抗纤维化特性,可能对预防腹膜粘连有益。本研究旨在分析在大鼠模型中给予维生素E与腹膜/腹腔内粘连之间的关系。

方法

截至2022年3月12日,在Scopus、PubMed、PMC和Cochrane图书馆数据库中使用特定关键词搜索相关文章。收集所有已发表的关于大鼠模型中维生素E与腹膜/腹部粘连的研究。使用Review Manager 5.4软件进行统计分析。

结果

最终分析纳入了9项研究。证据的汇总分析表明维生素E与显著降低腹膜/腹腔内粘连的发生率相关(风险比0.46;95%置信区间:0.33 - 0.64,P < 0.00001,I² = 61%,随机效应模型);以及粘连平均等级降低(平均差 -1.53;95%置信区间:-2.00,-1.06,P < 0.00001,I² = 98%,随机效应模型)。

结论

本研究表明补充维生素E可能对预防腹膜/腹腔内粘连有益。仍需要更多样本量更大且方法恰当的体内研究来证实本研究结果。如有可能,也有必要开展人体研究。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/a564/9422189/450a0aa07a4a/gr1.jpg

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