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结直肠癌手术中的手术部位感染：手术方式及相关危险因素影响的系统评价和荟萃分析

Surgical Site Infections in Colorectal Cancer Surgeries: A Systematic Review and Meta-Analysis of the Impact of Surgical Approach and Associated Risk Factors.

作者信息

Calu Valentin, Piriianu Catalin, Miron Adrian, Grigorean Valentin Titus

机构信息

Elias University Emergency Hospital, 011461 Bucharest, Romania.

Department of Surgery, Carol Davila University of Medicine and Pharmacy, 020021 Bucharest, Romania.

出版信息

Life (Basel). 2024 Jul 5;14(7):850. doi: 10.3390/life14070850.

DOI:10.3390/life14070850
PMID:39063604
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11278392/
Abstract

BACKGROUND

Surgical site infections (SSIs) represent a noteworthy contributor to both morbidity and mortality in the context of patients who undergo colorectal surgery. Several risk factors have been identified; however, their relative significance remains uncertain.

METHODS

We conducted a meta-analysis of observational studies from their inception up until 2023 that investigated risk factors for SSIs in colorectal surgery. A random-effects model was used to pool the data and calculate the odds ratio (OR) and 95% confidence interval (CI) for each risk factor.

RESULTS

Our analysis included 26 studies with a total of 61,426 patients. The pooled results showed that male sex (OR = 1.45), body mass index (BMI) ≥ 25 kg/m (OR = 1.09), American Society of Anesthesiologists (ASA) score ≥ 3 (OR = 1.69), were all independent risk factors for SSIs in colorectal surgery. Conversely, laparoscopic surgery (OR = 0.70) was found to be a protective factor.

CONCLUSIONS

The meta-analysis conducted revealed various risk factors, both modifiable and non-modifiable, associated with surgical site infections (SSIs) in colorectal surgery. These findings emphasize the significance of targeted interventions, including optimizing glycemic control, minimizing blood loss, and using laparoscopic techniques whenever feasible in order to decrease the occurrence of surgical site infections in this particular group of patients.

摘要

背景

手术部位感染（SSIs）是结直肠手术患者发病和死亡的一个重要因素。已确定了几个风险因素；然而，它们的相对重要性仍不确定。

方法

我们对从开始到2023年的观察性研究进行了荟萃分析，这些研究调查了结直肠手术中手术部位感染的风险因素。采用随机效应模型汇总数据，并计算每个风险因素的比值比（OR）和95%置信区间（CI）。

结果

我们的分析纳入了26项研究，共61426名患者。汇总结果显示，男性（OR = 1.45）、体重指数（BMI）≥25 kg/m²（OR = 1.09）、美国麻醉医师协会（ASA）评分≥3（OR = 1.69），均是结直肠手术中手术部位感染的独立风险因素。相反，腹腔镜手术（OR = 0.70）被发现是一个保护因素。

结论

所进行的荟萃分析揭示了与结直肠手术中手术部位感染（SSIs）相关的各种可改变和不可改变的风险因素。这些发现强调了针对性干预的重要性，包括优化血糖控制、尽量减少失血，并在可行时使用腹腔镜技术，以减少这一特定患者群体中手术部位感染的发生。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/572afc21a361/life-14-00850-g010.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/295bab060a43/life-14-00850-g001.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/63b097d50c11/life-14-00850-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/a5813d452acc/life-14-00850-g009.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/572afc21a361/life-14-00850-g010.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/328c7c267477/life-14-00850-g003.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/a50544af82a0/life-14-00850-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/6db765d58326/life-14-00850-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/63b097d50c11/life-14-00850-g008.jpg
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https://cdn.ncbi.nlm.nih.gov/pmc/blobs/d84c/11278392/572afc21a361/life-14-00850-g010.jpg

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