在直肠切除和肠道功能障碍后的解剖漏洞与肠道功能障碍之间的关联,系统性审查,元分析和元回归
Sameh Hany Emile1,2, Roberta Lynn Oslin1, Anjelli Wignakumar1
1Ellen Leifer Shulman and Steven Shulman Digestive Disease Center, Cleveland Clinic Florida, Weston, Florida, USA.
概括
结肠直肠手术后的解肠漏洞 (AL) 增加了低前切除综合征 (LARS) 的风险,这种疾病会导致肠道功能障碍. 患有AL的患者的LARS,紧迫性和抑郁得分明显更高.
科学领域:
- 结肠直肠手术 结肠直肠手术
- 胃肠病学 胃肠病学
- 临床结果研究研究
背景情况:
- 截面泄漏 (AL) 是结直肠手术后的一个已知的并发症.
- 通过促进肠道功能障碍,AL可以显著影响患者的生活质量.
- 低前切除综合征 (LARS) 是直肠手术的常见后果.
研究的目的:
- 为了评估前切除后的解肠漏 (AL) 与肠道功能障碍的发展之间的关联.
- 为了比较AL和没有AL的患者中LARS的发病率和严重程度.
- 评估其他肠道功能障碍症状,如便失禁和急迫性.
主要方法:
- 进行了符合PRISMA的系统审查.
- 在PubMed,Scopus和Cochrane图书馆搜索相关的随机和观察性研究.
- 进行了元分析,以确定LARS的相对风险 (RR),便失禁和紧急情况.
主要成果:
- 该审查包括了20项研究,涉及4764名患者;14%的患者经历过AL.
- 患有AL的患者患LARS (RR: 1.27) 和LARS (RR: 1.38) 的风险更高.
- 此外,AL还与急迫性增加 (RR: 1.15) 和较高的LARS和韦克斯纳失禁得分有关.
结论:
- 结直肠和结直肠腔解后的解漏明显与LARS风险增加有关.
- 证据表明,AL有助于主要LARS和急性症状的加剧.
- 患有AL的患者在LARS和便失禁评分系统上报告了更糟糕的结果.
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