Liu Xu-Rui, Zhang Bing-Lan, Peng Dong, Liu Fei, Li Zi-Wei, Wang Chun-Yi
Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Department of Gastroenterology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Updates Surg. 2024 Aug;76(4):1331-1338. doi: 10.1007/s13304-024-01864-w. Epub 2024 Jun 5.
The current study aimed to investigate whether previous abdominal surgery (PAS) could affect the outcomes of colorectal cancer (CRC) surgery. We conducted the search strategy in three databases (PubMed, Embase, and the Cochrane Library) from inception to May 26, 2022. The short-term and long-term outcomes were compared between the PAS group and the non-PAS group. Odds ratios (ORs) and 95% confidence intervals (CIs) were pooled up. Stata (V.16.0) software was used for data analysis. We included 34,827 patients from 14 studies in the current study. After pooling up all the data, we found that there were higher proportions of overall complications (OR = 1.12, I = 4.65%, 95% CI 1.03 to 1.23, P = 0.01), ileus (OR = 1.96, I = 59.74%, 95% CI 1.12 to 3.44, P = 0.02) and mortality (OR = 1.26, I = 0.00%, 95% CI 1.11 to 1.42, P = 0.00) in the PAS group than the non-PAS group. Patients with a history of PAS had higher risks of overall complications and death following CRC surgery. However, it did not appear to significantly affect the short-term outcomes apart from ileus. Surgeons should raise awareness of patients with a history of PAS, and take steps to reduce postoperative complications and mortality.
本研究旨在调查既往腹部手术（PAS）是否会影响结直肠癌（CRC）手术的结果。我们从建库至2022年5月26日在三个数据库（PubMed、Embase和Cochrane图书馆）中进行了检索策略。比较了PAS组和非PAS组的短期和长期结果。汇总了比值比（OR）和95%置信区间（CI）。使用Stata（V.16.0）软件进行数据分析。本研究纳入了14项研究中的34827例患者。汇总所有数据后，我们发现PAS组的总体并发症（OR = 1.12，I = 4.65%，95%CI 1.03至1.23，P = 0.01）、肠梗阻（OR = 1.96，I = 59.74%，95%CI 1.12至3.44，P = 0.02）和死亡率（OR = 1.26，I = 0.00%，95%CI 1.11至1.42，P = 0.00）的比例高于非PAS组。有PAS病史的患者在CRC手术后发生总体并发症和死亡的风险更高。然而，除肠梗阻外，它似乎并没有显著影响短期结果。外科医生应提高对有PAS病史患者的认识，并采取措施降低术后并发症和死亡率。
