在食道切除术期间不需要手术内胆道排水:对随机对照试验的元分析和系统审查
Armand Csontos1,2, Dávid Németh2,3, Lajos Szakó2,4,5
1Department of Surgery, Clinical Center, Medical School, University of Pécs, Pécs, Hungary.
Pathology oncology research : POR
|August 21, 2024
概括
在食道切除术后胃管重建期间,皮洛里克排水通常不需要. 这次元分析没有发现死亡率,泄漏率或发病率的显著差异,尽管胃排空时间的结果引起争议.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 医学统计 医学统计
背景情况:
- 最少侵入性食道切除术 (MIE) 为早期食道癌提供治愈治疗.
- 术内胆囊造形术是一种标准手术,但现在与MIE进行辩论.
- 在胃管重建中需要胆囊排水的必要性需要重新评估.
研究的目的:
- 为了比较胃管食道的食道重建与没有胆囊造形术.
- 为了评估胆囊造形术对食道切除术后患者结局的影响.
- 评估在最小侵入性食道切除术中胆囊排水的必要性.
主要方法:
- 进行了随机对照试验 (RCT) 的系统搜索.
- 两个独立的审查员根据预先定义的标准选择了研究.
- 统计分析,包括偏见和质量评估,对9个RCT (529名患者) 的数据进行.
主要成果:
- 在死亡率,解漏,呼吸道发病率或吐方面没有发现显著差异.
- 胃排空时间 (GET) 的结果引起争议,具有显著的异质性.
- 试验序列分析表明需要更多数据,除了二进制GET变量.
结论:
- 在胃管道重建中,平流排水程序不是常规必要的.
- 需要进一步进行高质量的研究,才能确定胆囊造形术的作用.
- 为欧洲人群提出了具体的建议.
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