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Received:May 26, 2022 Published Online:February 20, 2023
Received:May 26, 2022 Published Online:February 20, 2023
中文摘要: 目的 系统性评价食管胃结合部腺癌切除术后不同消化道重建方式的预后疗效。方法 通过检索国内外数据库,收集2016年1月到2022年5月发表的对比食管残胃吻合术(EG)、食管空肠Roux-en-Y吻合术及双通道吻合术(DTR)三种消化道重建方式的相关文献,由研究员筛选文献并提取资料后,进行网状Meta分析。结果 最终纳入34篇文献,共2 876例患者。Meta分析结果显示,在三种消化道重建方式中DTR在术后预防反流性食管炎、肠梗阻、吻合口漏等并发症发生率,术后6个月白蛋白、血红蛋白、总蛋白水平方面优于EG、食管空肠Roux-en-Y吻合术(P<0.05)。结论 三种消化道重建方式中DTR抗反流效果好,能有效预防术后各种并发症的发生,而且患者术后营养好、恢复快,手术近期预后良好。
Abstract:ObjectiveTo systematically evaluate the prognostic efficacy of various gastrointestinal reconstruction modalities after esophagogastric union cancer resection. MethodsThe literature comparing the three gastrointestinal reconstruction modalities of esophageal remnant gastric anastomosis (EG), esophageal jejunal Roux-en-Y anastomosis and dual channel anastomosis (DTR) published from January 2016 to May 2022 were collected by searching domestic and foreign databases, and the literature was screened and extracted by the researcher before performing a network Meta-analysis. ResultsThirty-four literatures with a total of 2 876 patients were included in the study. Meta-analysis results showed that DTR performed best in terms of postoperative complication rates such as prevention of reflux esophagitis, intestinal obstruction and anastomotic leakage, and in terms of albumin, haemoglobin and total protein levels at 6 months postoperatively(P<0.05). ConclusionOf the three gastrointestinal reconstruction modalities, DTR has a good anti-reflux effect and can effectively prevent various post-operative complications, and the patient has good post-operative nutrition, a rapid recovery and a good prognosis for the immediate future of the procedure.
keywords: Gastric cancer Gastrointestinal reconstruction Esophagogastric junction adenocarcinoma Esophagogastro-stomy Oesophagojejunostomy Roux-en-Y anastomosis Double-tract reconstruction Network Meta-analysis
文章编号: 中图分类号: 文献标志码:A
基金项目:无锡市卫健委面上项目(M202168);无锡市卫健委中青年拔尖人才资助计划(HB2020007)
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