更新对预防门的证据的系统审查,元分析和GRADE评估-A EHS,ESCP和EAES合作项目
Alexander A Tzanis1, Cesare Stabilini2, Filip E Muysoms3
1Metaxa Memorial Cancer Hospital, Piraeus, Greece.
Journal of abdominal wall surgery : JAWS
|February 5, 2024
概括
在末端结肠直肠切割过程中,预防性网状放置可能会降低半体的风险,而不会增加重大并发症或影响生活质量. 本系统性审查总结了关于口腔构造的欧洲指导方针的证据.
科学领域:
- 手术瘤学手术瘤学
- 胃肠病学 胃肠病学
- 基于证据的医学基于证据的医学.
背景情况:
- 偏肠是结尾结肠直肠切除术后的一个常见并发症.
- 预防性网状布置是一种备受辩论的预防半身的策略.
- 现有证据需要综合用于临床指南的制定.
研究的目的:
- 系统地审查和分析预防性网的有效性,以防止在结肠直肠切除术后的半体.
- 评估预防网对生活质量,发病率,后续手术和术后并发症的影响.
- 提供证据,为一个跨学科的欧洲快速指导方针,对口腔管道管理.
主要方法:
- 更新的系统审查与新的证据搜索 (PubMed,到2022年6月).
- 包括12个随机试验,评估预防性网格与没有网格.
- 结果:生活质量,半体诊断,半体手术,克拉维恩-丁多≥3次并发症. 使用RoB 2工具评估偏差风险;用GRADE评估证据.
主要成果:
- 生活质量没有显著差异 (SMD = 0.03,低确定性证据).
- 预防性合成网格显著降低了半体发生率 (OR = 0.33,中等确定性证据).
- 在手术中没有显著的差异,用于半体 (OR = 0.52) 或重大并发症 (OR = 0.77,低确定性证据).
结论:
- 在结肠架构末端的预防性合成网可能会降低半体的风险.
- 与没有网格相比,网格放置似乎具有类似的重大外科手术前病率风险.
- 在两种方法之间没有观察到生活质量或需要半体修复的差异.
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