Xie Yunhui, Wen Jun, Zhu Hongmei, Liu Yanjun
Center of Gastrointestinal and Minimally Invasive Surgery, Department of General Surgery, The Third People's Hospital of Chengdu, Affiliated Hospital of Southwest Jiaotong University, Chengdu, China.
College of Medicine, Southwest Jiaotong University, Chengdu, China.
JMIR Res Protoc. 2023 Dec 22;12:e50677. doi: 10.2196/50677.
BACKGROUND: The effects of reinforcement are still controversial in bariatric surgery, and variations may exist in using this technique. OBJECTIVE: This protocol describes a study that aims to survey the views of bariatric surgeons on reinforcement techniques and evaluate the effects of applying reinforcement techniques in sleeve gastrectomy (SG) and Roux-en-Y gastric bypass (RYGB). METHODS: This study is composed of 2 parts. Part 1 will investigate the differences of using reinforcement techniques among surgeons worldwide who perform SG or RYGB through a survey. The survey will be conducted by email and social media. Part 2 will evaluate the safety and effectiveness of using omentopexy or staple line reinforcement in SG and RYGB by systematic review and meta-analysis. In this part, literature searches will be performed in English databases, including CENTRAL, EMBASE CINAHL, Web of Science, and PubMed, and Chinese databases, including Wanfang, China National Knowledge Infrastructure, Database of Chinese Technical Periodicals, and Chinese Biological Medicine, from their establishment to November 2023. Randomized controlled trials and case-control studies will be included. The primary outcomes are rates of postoperative bleeding and gastric leakage. The secondary outcomes include anastomotic stenosis, surgical site infection, reoperation, estimated intraoperative blood loss, operative time (minutes), length of hospital stay (days), overall complications, and 30-day mortality. The meta-analysis will be conducted using RevMan 5.4 under the random-effects model, as well as through extensive subgroup and sensitivity analyses. P values <0.05 will be considered statistically significant. This study was registered with PROSPERO (Prospective Register of Systematic Reviews) in accordance with the PRISMA-P (Preferred Reporting Items for Systematic Review and Meta-Analysis Protocols). RESULTS: The results of this study will be published in a peer-reviewed journal. The web-based survey and initial title or abstract review of papers identified by the search strategy will be completed in November 2023. The second round of title or abstract review and downloading of the papers for full-text inclusion will be completed in January 2024. We aim to complete data extraction and meta-analysis by February 2024 and expect to publish the findings by the end of March 2024. CONCLUSIONS: This study aims to investigate the impact of reinforcement techniques on reducing the incidence of postoperative complications in SG and RYGB procedures and provide assistance for standardizing the procedures of SG and RYGB operations for bariatric surgeons. TRIAL REGISTRATION: PROSPERO CRD42022376438; https://tinyurl.com/2d53uf8n. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): PRR1-10.2196/50677.
背景:强化技术在减重手术中的效果仍存在争议,且在使用该技术时可能存在差异。 目的:本方案描述了一项研究,旨在调查减重外科医生对强化技术的看法,并评估在袖状胃切除术(SG)和 Roux-en-Y 胃旁路术(RYGB)中应用强化技术的效果。 方法:本研究由两部分组成。第 1 部分将通过一项调查研究全球范围内进行 SG 或 RYGB 手术的外科医生在使用强化技术方面的差异。该调查将通过电子邮件和社交媒体进行。第 2 部分将通过系统评价和荟萃分析评估在 SG 和 RYGB 中使用网膜固定术或吻合器缝线加固的安全性和有效性。在这一部分,将在英文数据库(包括 CENTRAL、EMBASE、CINAHL、Web of Science 和 PubMed)以及中文数据库(包括万方、中国知网、中国科技期刊数据库和中国生物医学数据库)中进行文献检索,检索时间范围从数据库建立至 2023 年 11 月。将纳入随机对照试验和病例对照研究。主要结局是术后出血和胃漏的发生率。次要结局包括吻合口狭窄、手术部位感染、再次手术、估计术中失血量、手术时间(分钟)、住院时间(天)、总体并发症和 30 天死亡率。将使用 RevMan 5.4 在随机效应模型下进行荟萃分析,并进行广泛的亚组分析和敏感性分析。P 值<0.05 将被视为具有统计学意义。本研究已按照 PRISMA-P(系统评价和荟萃分析方案的首选报告项目)在 PROSPERO(系统评价前瞻性注册库)注册。 结果:本研究结果将发表在同行评审期刊上。基于网络的调查以及对通过检索策略确定的论文进行的初步标题或摘要评审将于 2023 年 11 月完成。第二轮标题或摘要评审以及下载全文纳入的论文将于 2024 年 1 月完成。我们的目标是在 2024 年 2 月前完成数据提取和荟萃分析,并预计在 2024 年 3 月底前发表研究结果。 结论:本研究旨在探讨强化技术对降低 SG 和 RYGB 手术术后并发症发生率的影响,并为减重外科医生规范 SG 和 RYGB 手术操作提供帮助。 试验注册:PROSPERO CRD42022376438;https://tinyurl.com/2d53uf8n。 国际注册报告识别号(IRRID):PRR1-10.2196/50677。
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