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透析患者结直肠癌手术的短期结局:系统评价和荟萃分析。

Short-term outcomes of colorectal cancer surgery in patients with dialysis: a systematic review and meta-analysis.

机构信息

Department of Surgery, Tokyo General Hospital, 3-15-2, Ekoda, Nakano, Tokyo, 165-8906, Japan.

出版信息

Langenbecks Arch Surg. 2023 Jul 18;408(1):283. doi: 10.1007/s00423-023-03016-x.

Abstract

PURPOSE

This systematic review and meta-analysis aimed to evaluate the effect of dialysis-dependent chronic kidney disease (CKD) on postoperative complications in colorectal cancer surgery.

METHODS

In April 2023, we systematically searched PubMed, the Cochrane library, and Ovid for relevant studies on short-term outcomes of colorectal cancer surgery in patients with dialysis and analyzed the findings from these studies for meta-analysis.

RESULTS

Our systematic and meta-analysis review identified seven studies involving 50713 patients. We showed that the dialysis group had higher rates of mortality (OR = 4.12, 95%CI: 2.75-6.20, P < 0.001), cardiac complications (OR = 2.45, 95%CI: 1.88-3.21, P < 0.001), and pneumonia (OR = 2.68, 95%CI: 1.83-3.93, P < 0.001). On the other hand, there were no differences in superficial/deep surgical site infection (SSI) (odds ratio [OR] = 1.17, 95%CI: 0.90-1.53, P = 0.230) and organ/space SSI (OR = 1.35, 95%CI: 1.00-1.82, P = 0.053) between the dialysis group and non-dialysis group.

CONCLUSION

Our meta-analysis showed that dialysis-dependent CKD was associated with higher rates of mortality, cardiac complications, and pneumonia after colorectal cancer surgery. However, the limitations of this meta-analysis should be taken into consideration when interpreting the results.

摘要

目的

本系统评价和荟萃分析旨在评估透析依赖性慢性肾脏病(CKD)对结直肠癌手术术后并发症的影响。

方法

2023 年 4 月,我们系统地检索了 PubMed、Cochrane 图书馆和 Ovid 中关于透析患者结直肠癌手术短期结局的相关研究,并对这些研究的结果进行荟萃分析。

结果

我们的系统和荟萃分析综述共确定了 7 项涉及 50713 例患者的研究。结果表明,透析组的死亡率(OR=4.12,95%CI:2.75-6.20,P<0.001)、心脏并发症(OR=2.45,95%CI:1.88-3.21,P<0.001)和肺炎(OR=2.68,95%CI:1.83-3.93,P<0.001)发生率更高。另一方面,透析组与非透析组在浅表/深部手术部位感染(SSI)(比值比[OR]=1.17,95%CI:0.90-1.53,P=0.230)和器官/空间 SSI(OR=1.35,95%CI:1.00-1.82,P=0.053)发生率方面无差异。

结论

本荟萃分析表明,透析依赖型 CKD 与结直肠癌手术后死亡率、心脏并发症和肺炎发生率升高有关。然而,在解释结果时应考虑到本荟萃分析的局限性。

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