Liu Ying-Ning, Gu Jing-Feng, Zhang Jian, Xing Dong-Yang, Wang Gui-Qi
Department of Gastrointestinal Surgery, The First Hospital of Hebei Medical University, Shijiazhuang 050011, Hebei Province, China.
World J Gastrointest Surg. 2023 Oct 27;15(10):2331-2342. doi: 10.4240/wjgs.v15.i10.2331.
Colorectal cancer ranks third in global cancer prevalence and stands as the second leading cause of cancer-related mortalities. With obesity recognized as a pivotal risk factor for colorectal cancer, the potential protective role of bariatric surgery, especially laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy, has garnered attention.
To investigate the Roux-en-Y gastric bypass (RYGB) sleeve gastrectomy (SG) effect on colorectal cancer incidence in obese individuals.
A systematic review and meta-analysis of the literature was conducted following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. Seventeen studies with a total of 12497322 patients were included. The primary outcome was the relative risk (RR) of developing colorectal cancer in obese patients who underwent weight loss surgery compared to those who did not. Secondary outcomes included determining the RR for colon and rectal cancer separately and subgroup analyses by gender and type of weight loss surgery.
The meta-analysis revealed a 54% reduction in colorectal cancer risk in morbidly obese patients who underwent bariatric surgery compared to those who did not. A significant 46% reduction in colorectal cancer risk was observed among female patients. However, no significant differences were found in the meta-analysis for various types of bariatric surgery, such as SG and RYGB.
This meta-analysis reveals weight loss surgery, regardless of type, reduces colorectal cancer risk, especially in women, as indicated by RR and hazard ratio assessments. Further validation is essential.
结直肠癌在全球癌症患病率中排名第三，是癌症相关死亡的第二大主要原因。肥胖被认为是结直肠癌的一个关键风险因素，减重手术，尤其是腹腔镜Roux-en-Y胃旁路手术和腹腔镜袖状胃切除术的潜在保护作用已引起关注。
研究Roux-en-Y胃旁路手术（RYGB）和袖状胃切除术（SG）对肥胖个体结直肠癌发病率的影响。
按照系统评价和Meta分析的首选报告项目进行文献的系统评价和Meta分析。纳入了17项研究，共12497322例患者。主要结局是接受减重手术的肥胖患者与未接受减重手术的肥胖患者相比患结直肠癌的相对风险（RR）。次要结局包括分别确定结肠癌和直肠癌的RR，以及按性别和减重手术类型进行亚组分析。
Meta分析显示，与未接受减重手术的病态肥胖患者相比，接受减重手术的患者患结直肠癌的风险降低了54%。女性患者患结直肠癌的风险显著降低了46%。然而，在Meta分析中，SG和RYGB等各种类型的减重手术之间未发现显著差异。
该Meta分析表明，无论何种类型，减重手术均可降低结直肠癌风险，尤其是女性，RR和风险比评估表明了这一点。进一步验证至关重要。
