Department of Surgery, Tokyo General Hospital, 3-15-2, Ekoda, Nakano, Tokyo, 165-8906, Japan.
Langenbecks Arch Surg. 2023 Jul 18;408(1):283. doi: 10.1007/s00423-023-03016-x.
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.
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.
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.
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.
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。
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。
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。
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。
