机械与手工食管胃吻合术后吻合口瘘发生率比较的系统评价

发布时间：2018-06-01 23:55

本文选题：食管胃吻合术 + 吻合口瘘　；参考：《中国循证医学杂志》2012年11期

【摘要】：目的系统评价机械与手工食管胃吻合术后吻合口瘘发生率。方法计算机检索CBM(1978～2012.2)、VIP(1989～2012.2)、CNKI(1994～2012.2)、WanFang Data(1980～2012.2)、The Cochrane Library、PubMed(1966～2012.2)、EMbase(1974～2012.2)以及相关临床试验网站,查找比较机械与手工食管胃吻合术后患者吻合口瘘发生率的随机和半随机对照试验,并运用Google Scholar、Medical Martix等搜索引擎,查找相关参考文献及灰色文献,手工检索《中华肿瘤学》等相关中文期刊。按照纳入和排除标准筛选文献、提取资料并评价纳入研究的方法学质量后,采用RevMan 5.0软件进行Meta分析。结果最终纳入9个RCT,2 202例患者。Meta分析结果显示:机械吻合术后患者吻合口瘘发生率低于手工吻合[OR=0.43,95%CI(0.26,0.71),P0.01]。结论机械吻合在降低食管胃吻合术后患者吻合口瘘发生率方面优于手工吻合。受纳入研究质量和数量限制,上述结论尚需开展更多高质量研究加以验证。
[Abstract]:Objective to evaluate the incidence of anastomotic fistula after mechanical and manual esophagogastric anastomosis. Methods A computerized search was conducted on the Cochrane Library Cochrane Meden (1978-22) and related clinical trial sites to find out the random and semi-randomized controlled trials comparing the incidence of anastomotic fistula in patients undergoing mechanical and manual esophagogastrostomy anastomosis, using Google Scholarn Medical Martix search engine, and other search engines, using Google Scholarn Medical Martix and other search engines, for the purpose of searching for the CBM (1978-22) VIPA (1989 / 22) and CNKI (1994 / 22 / 2012) and the related clinical trial sites, respectively, in which the incidence of anastomotic fistula in patients undergoing mechanical and manual esophagogastric anastomosis was compared with that of Google Scholarr Medical Martix search engine, and search engines such as Google Scholarn Medical Martix and so on. To search the relevant references and grey documents, and to search the Chinese periodicals such as Chinese Oncology by hand. The literature was screened according to the inclusion and exclusion criteria, the data was extracted and the methodological quality of the study was evaluated, and the Meta analysis was carried out with RevMan 5.0 software. Results the results of meta-analysis showed that the incidence of anastomotic leakage in patients after mechanical anastomosis was lower than that in manual anastomosis. Conclusion Mechanical anastomosis is superior to manual anastomosis in reducing the incidence of anastomotic fistula after esophagogastrostomy. These conclusions need to be verified by more high-quality studies, which are limited by the quality and quantity of the research.
【作者单位】：兰州大学第一临床医学院;兰州大学第一附属医院;
【分类号】：R735

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