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短期与长期抗菌预防方案在胃癌手术中的疗效比较:一项随机对照试验的荟萃分析。

Efficacy of the Short-Term versus Long-Term Administration of Antimicrobial Prophylaxis in Gastric Cancer Surgery: A Meta-Analysis of Randomized Controlled Trials.

机构信息

Yantai Yuhuangding Hospital, Shandong University, Yantai, Shandong, China.

Department of Gastrointestinal Surgery, The Affiliated Yantai Yuhuangding Hospital of Qingdao University, Yantai, Shandong, China.

出版信息

Surg Infect (Larchmt). 2022 Sep;23(7):625-633. doi: 10.1089/sur.2022.179.

DOI:10.1089/sur.2022.179
PMID:36049075
Abstract

We performed a meta-analysis to confirm the efficacy of short-term compared with long-term administration of antimicrobial prophylaxis in gastric cancer surgery. Randomized controlled trials of the efficacy of short-term versus long-term administration of antimicrobial prophylaxis in gastric cancer surgery were searched using the MEDLINE, EMBASE, and the Cochrane Controlled Trials Register databases. The data were evaluated and statistically analyzed using RevMan version 5.3.0. Five studies including 2,053 participants who received short-term versus long-term administration of antimicrobial prophylaxis in gastric cancer surgery were considered. There was no significant difference in the surgical site infection (SSI) rate between the short-term group and the long-term group (8.1% vs. 9.2%; odds ratio [OR], 0.87; 95% confidence interval [CI], 0.64-1.09; p = 0.39). Hierarchical analysis also showed no significant differences in incisional-site incisions, organ/space incisions, or leakage. Multivariable analysis showed no significant differences in gender, age (>65 years), body mass index (>25 kg/m), D2, operation time (>3 hours), pathologic stage 3, blood loss, combined resection, diabetes mellitus, total gastrectomy, or blood transfusion between the two groups. Short-term administration of antimicrobial prophylaxis did not increase the incidence of SSIs after gastrectomy.

摘要

我们进行了一项荟萃分析,以确认短期与长期使用抗菌预防药物在胃癌手术中的疗效。使用 MEDLINE、EMBASE 和 Cochrane 对照试验登记数据库搜索了短期与长期使用抗菌预防药物在胃癌手术中的疗效的随机对照试验。使用 RevMan 版本 5.3.0 对数据进行评估和统计学分析。纳入了 5 项研究,共 2053 例接受短期或长期抗菌预防药物治疗的胃癌手术患者。短期组和长期组的手术部位感染(SSI)发生率无显著差异(8.1% vs. 9.2%;比值比[OR],0.87;95%置信区间[CI],0.64-1.09;p=0.39)。分层分析也显示,切口部位、器官/间隙部位或渗漏的发生率无显著差异。多变量分析显示,两组间的性别、年龄(>65 岁)、体重指数(>25 kg/m)、D2、手术时间(>3 小时)、病理分期 3、出血量、联合切除、糖尿病、全胃切除术或输血均无显著差异。短期使用抗菌预防药物并不会增加胃癌手术后 SSI 的发生率。

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