术中失血对结直肠癌患者术后并发症及预后的影响:一项荟萃分析

Effect of intraoperative blood loss on postoperative complications and prognosis of patients with colorectal cancer: A meta‑analysis.

作者信息

Li Zi-Wei, Shu Xin-Peng, Wen Ze-Lin, Liu Fei, Liu Xu-Rui, Lv Quan, Liu Xiao-Yu, Zhang Wei, Peng Dong

机构信息

Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing 400016, P.R. China.

Department of Gastrointestinal Surgery, Yongchuan Hospital of Chongqing Medical University, Chongqing 402160, P.R. China.

出版信息

Biomed Rep. 2023 Dec 14;20(2):22. doi: 10.3892/br.2023.1710. eCollection 2024 Feb.

Abstract

The purpose of the present study was to evaluate whether the amount of intraoperative blood loss (IBL) affects the complications and prognosis of patients with colorectal cancer (CRC). The PubMed, EMBASE and the Cochrane Library databases were used to search for eligible studies from inception to November 30, 2020. Hazard ratios (HRs) and 95% confidence intervals (Cls) were pooled up. The overall survival (OS) and disease-free survival (DFS) were compared between the larger IBL group and the smaller IBL group. The present study was performed with RevMan 5.3 (The Cochrane Collaboration). A total of seven studies involving 1,540 patients with CRC were included in the present study. The smaller IBL group had a higher rate of OS (HR=1.45, 95% CI=1.17 to 1.8, P=0.0007) and a higher rate of DFS (HR=1.76, 95% CI=1.40 to 2.21, P<0.00001). Furthermore, the larger IBL group had a higher rate of postoperative complications than the smaller IBL group (odds ratio=2.06, 95% CI=1.72 to 2.15, P<0.00001). In conclusion, a smaller IBL was associated with better OS and DFS, and a lower risk of postoperative complications compared with a larger IBL in patients with CRC, suggesting that surgeons should pay more attention during perioperative management and surgical operation to reduce IBL.

摘要

本研究的目的是评估术中失血量(IBL)是否会影响结直肠癌(CRC)患者的并发症和预后。使用PubMed、EMBASE和Cochrane图书馆数据库检索从数据库建立至2020年11月30日的符合条件的研究。汇总风险比(HRs)和95%置信区间(Cls)。比较大IBL组和小IBL组的总生存期(OS)和无病生存期(DFS)。本研究使用RevMan 5.3(Cochrane协作网)进行。本研究共纳入7项涉及1540例CRC患者的研究。小IBL组的OS率较高(HR=1.45,95%CI=1.17至1.8,P=0.0007),DFS率也较高(HR=1.76,95%CI=1.40至2.21,P<0.00001)。此外,大IBL组的术后并发症发生率高于小IBL组(优势比=2.06,95%CI=1.72至2.15,P<0.00001)。总之,与大IBL相比,小IBL与CRC患者更好的OS和DFS相关,且术后并发症风险更低,这表明外科医生在围手术期管理和手术操作过程中应更加注意减少IBL。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/64fd/10758914/316d83e75d39/br-20-02-01710-g00.jpg

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