Hou Zhuoer, Liu Ting, Li Xiaoyan, Lv Hangpeng, Sun Qiuhua
The School of Nursing, Zhejiang Chinese Medical University, Hangzhou, China.
The School of Basic Medicine, Zhejiang Chinese Medical University, Hangzhou, China.
PLoS One. 2024 Aug 1;19(8):e0308175. doi: 10.1371/journal.pone.0308175. eCollection 2024.
The study intended to evaluate the risk factors of postoperative ileus in hysterectomy patients.
Systematic review and meta-analysis.
This study conducted a systematic review and meta-analysis in accordance with the Preferred Reporting Program for Systematic Review and Meta-analysis statement. PubMed, Web of Science, Embase, the Cochrane Library and China National Knowledge Internet were searched. The search period was restricted from the earliest records to March 2024. Key words used were: (hysterectomy) AND (postoperative ileus OR postoperative intestinal obstruction OR ileus OR intestinal obstruction). Two researchers screened literatures and extracted data, and used Newcastle-Ottawa scale and Joanna Briggs Institute critical appraisal checklist for analytical cross-sectional studies to evaluate their quality. Then, Stata17 software was used for statistical analysis.
A total of 11 literatures were included. Personal factors and previous history of disease factors of postoperative ileus in hysterectomy patients included use opioids (OR = 3.91, 95%CI: 1.08-14.24), dysmenorrhea (OR = 2.51, 95%: 1.25-5.05), smoking (OR = 1.55, 95%: 1.18-2.02), prior abdominal or pelvic surgery (OR = 1.46, 95%CI: 1.16-1.83) and age (OR = 1.03, 95%: 1.02-1.04). Surgery-related factors included perioperative transfusion (OR = 4.50, 95%CI: 3.29-6.16), concomitant bowel surgery (OR = 3.79, 95%CI: 1.86-7.71), anesthesia technique (general anesthesia) (OR = 2.73, 95%CI: 1.60, 4.66), adhesiolysis (OR = 1.97, 95%CI: 1.52-2.56), duration of operation (OR = 1.78, 95%CI: 1.32-2.40), operation approach (laparoscopic hysterectomy) (OR = 0.43, 95%CI: 0.29-0.64) and operation approach (vaginal hysterectomy) (OR = 0.35, 95%CI: 0.18-0.69).
The results of this study were personal factors and previous history of disease factors, surgery-related factors, which may increase the risk of postoperative ileus in hysterectomy patients. After the conclusion of risk factors, more accurate screening and identification of high-risk groups can be conducted and timely preventive measures can be taken to reduce the incidence of postoperative ileus.
The study protocol for this meta-analysis was registered (CRD42023407167) with the PROSPERO database (www.crd.york.ac.uk/prospero).
本研究旨在评估子宫切除术患者术后肠梗阻的危险因素。
系统评价和荟萃分析。
本研究按照系统评价和荟萃分析的首选报告程序声明进行系统评价和荟萃分析。检索了PubMed、科学网、Embase、考克兰图书馆和中国知网。检索期限从最早记录到2024年3月。使用的关键词为：（子宫切除术）AND（术后肠梗阻或术后肠粘连或肠梗阻或肠粘连）。两名研究人员筛选文献并提取数据，并使用纽卡斯尔-渥太华量表和乔安娜·布里格斯研究所分析性横断面研究的批判性评价清单来评估其质量。然后，使用Stata17软件进行统计分析。
共纳入11篇文献。子宫切除术患者术后肠梗阻的个人因素和既往病史因素包括使用阿片类药物（OR = 3.91，95%CI：1.08 - 14.24）、痛经（OR = 2.51，95%：1.25 - 5.05）、吸烟（OR = 1.55，95%：1.18 - 2.02）、既往腹部或盆腔手术（OR = 1.46，95%CI：1.16 - 1.83）和年龄（OR = 1.03，95%：1.02 - 1.04）。手术相关因素包括围手术期输血（OR = 4.50，95%CI：3.29 - 6.16）、同期肠道手术（OR = 3.79，95%CI：1.86 - 7.71）、麻醉技术（全身麻醉）（OR = 2.73，95%CI：1.60，4.66）、粘连松解术（OR = 1.97，95%CI：1.52 - 2.56）、手术时间（OR = 1.78，95%CI：1.32 - 2.40）、手术方式（腹腔镜子宫切除术）（OR = 0.43，95%CI：0.29 - 0.64）和手术方式（阴道子宫切除术）（OR = 0.35，95%CI：0.18 - 0.69）。
本研究结果为个人因素和既往病史因素、手术相关因素，这些因素可能增加子宫切除术患者术后肠梗阻的风险。在明确危险因素后，可以更准确地筛查和识别高危人群，并及时采取预防措施以降低术后肠梗阻的发生率。
本荟萃分析的研究方案已在PROSPERO数据库（www.crd.york.ac.uk/prospero）注册（CRD42023407167）。
