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大动脉化是结直肠静脉泄漏的危险因素之一
Xu-Rui Liu1, Fei Liu1, Wei Zhang1
1Department of Gastrointestinal Surgery, The First Affiliated Hospital of Chongqing Medical University, Chongqing, 400016, China.
Updates in surgery
|August 18, 2023
概括
大动脉化 (AC) 在结直肠手术后显著增加了解静脉泄漏 (AL) 的风险. 这一发现适用于一般的结直肠手术和特别是结直肠癌 (CRC) 手术.
科学领域:
- 心血管医学 心血管医学
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
背景情况:
- 解剖管泄漏 (AL) 是结直肠手术后的一种严重并发症.
- 确定AL的手术前风险因素对于患者管理至关重要.
- 大动脉化 (AC) 是系统性动脉样硬化的标志物.
研究的目的:
- 评估大动脉化 (AC) 是否是结直肠手术后道泄漏 (AL) 的潜在危险因素.
- 通过对现有研究的综合分析,调查AC和AL之间的关联.
- 确定AC是否预测特定结直肠外科手术亚组中的AL,包括结直肠癌 (CRC).
主要方法:
- 在PubMed,Embase和Cochrane图书馆进行了系统的文献搜索.
- 从涉及1955名患者的8项符合条件的研究中收集的数据被聚合在一起进行元分析.
- 使用RevMan 5.3计算危险比率 (HRs) 和95%置信区间 (CI),并遵循PRISMA指南.
主要成果:
- 发现大动脉化 (AC) 在结直肠手术后显著增加了解静脉泄漏 (AL) 的风险 (HR = 2.31,P < 0.01).
- 在包括患有良性疾病和癌症的患者在内的五项研究的小组中,AC仍然是AL的重要风险因素 (HR = 3.30,P < 0.01).
- 对三项专注于结直肠癌 (CRC) 患者的研究的分析也表明,AC和AL之间存在显著的关联 (HR = 1.80,P = 0.02).
结论:
- 患有大动脉化 (AC) 的患者在结直肠手术后更有可能患上解静脉泄漏 (AL).
- 亚组分析证实,AC是AL的重要预测因素,特别是在结直肠癌 (CRC) 手术的背景下.
- 这些发现凸显了在对结直肠手术进行手术前风险评估时,将AC视为潜在的风险因素的重要性.
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