切除和非切除手术方法治疗西格体卷发症的复发率和死亡率的比较:系统性审查和元分析
Xiaomei Jiang1, Siqi Guo1, Lie Yang2,3
1Division of Gastrointestinal Surgery, Department of General Surgery, West China Hospital of Sichuan University, No. 37 Guoxue Lane, Chengdu, 610041, Sichuan, China.
Langenbeck's archives of surgery
|December 15, 2025
概括
对西格体卷积 (SV) 的切除手术显著减少复发,但可能增加死亡率. 然而,在具有可活性结肠的患者中,切除有效地防止复发,而不会显著增加死亡率,支持在特定情况下使用它.
科学领域:
- 胃肠病学 胃肠病学
- 手术瘤学手术瘤学
- 临床流行病学 临床流行病学
背景情况:
- 西格体卷发症 (SV) 是大肠阻塞的常见原因,特别是在某些人群中.
- 治疗SV需要在预防复发和尽量减少手术后死亡率之间取得平衡.
- 手术选择包括切除和各种非切除技术.
研究的目的:
- 系统地审查和元分析切除与非切除手术的复发率和死亡率.
- 为了比较SV管理手术方法的疗效和安全性.
主要方法:
- 在主要数据库 (PubMed,EMBASE,科学网,柯克兰图书馆) 进行了全面的文献搜索.
- 包括比较SV切除和非切除手术的研究.
- 采用随机效应模型,将复发率和死亡率数据汇集在一起.
主要成果:
- 切除显著降低了复发率 (RR:0.12),但与死亡率增加有关 (RR:1.69).
- 在不包括患有瘤性西格的患者的亚组分析中,切除有效地预防了复发 (RR:0.20),而没有显著增加死亡率 (RR:1.12).
- 敏感性分析支持了这些发现,包括与特定非切除程序的比较.
结论:
- 切除手术是有效的预防sigmoid volvulus复发.
- 在具有可活性结肠的患者中,切除并不会显著增加死亡率,是合适的选择.
- 未来的研究应该专注于优化患者选择和SV的术后护理.
更多相关视频
08:26Clinical Application of Single-Surgeon, Three-Port, Laparoscopic Resection for Colorectal Cancer with Natural Orifice Specimen Extraction
Published on: March 24, 2023
1.3K
12:45Robot-assisted Total Mesorectal Excision and Lateral Pelvic Lymph Node Dissection for Locally Advanced Middle-low Rectal Cancer
Published on: February 12, 2022
6.4K
相关概念视频
Endoscopic Procedures IV: Sigmoidoscopy and Laproscopy
514
Sigmoidoscopy and laparoscopy are distinct medical procedures that enable physicians to internally inspect different parts of the GI tract. Although they serve different purposes, each is essential for diagnosing and, in some cases, treating various medical conditions.
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
Sigmoidoscopy
Sigmoidoscopy is a diagnostic procedure that uses a flexible sigmoidoscope equipped with a light source and camera to examine the rectum and sigmoid colon. The procedure involves inserting the tube through the anus...
514
Inflammatory Bowel Disease V: Surgical Management
424
Surgical interventions for inflammatory bowel disease (IBD), which includes ulcerative colitis and Crohn's disease, are essential in managing symptoms and addressing complications. The selection of surgical procedures is contingent upon the specific conditions and complications that stem from these illnesses.
Here are some common surgical interventions for IBD:
Here are some common surgical interventions for IBD:
424
