Genitourinary function and defecation after colorectal cancer surgery with low-and high-ligation of the inferior mesenteric artery:A meta-analysis  

作　　者：Xiao Bai Chun-Dong Zhang Jun-Peng Pei Dong-Qiu Dai 

机构地区：[1]Department of Gastrointestinal Surgery,the Fourth Affiliated Hospital of China Medical University,Shenyang 110032,Liaoning Province,China [2]Department of Gastrointestinal Surgery,Graduate School of Medicine,The University of Tokyo,Tokyo 113-0033,Japan [3]Cancer Center,the Fourth Affiliated Hospital of China Medical University,Shenyang 110032,Liaoning Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2021年第8期871-884,共14页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND The effect of low ligation(LL)vs high ligation(HL)of the inferior mesenteric artery(IMA)on functional outcomes during sigmoid colon and rectal cancer surgery,including urinary,sexual,and bowel function,is still controversial.AIM To assess the effect of LL of the IMA on genitourinary function and defecation after colorectal cancer(CRC)surgery.METHODS EMBASE,PubMed,Web of Science,and the Cochrane Library were systematically searched to retrieve studies describing sigmoid colon and rectal cancer surgery in order to compare outcomes following LL and HL.A total of 14 articles,including 4750 patients,were analyzed using Review Manager 5.3 software.Dichotomous results are expressed as odds ratios(ORs)with 95%confidence intervals(CIs)and continuous outcomes are expressed as weighted mean differences(WMDs)with 95%CIs.RESULTS LL resulted in a significantly lower incidence of nocturnal bowel movement(OR=0.73,95%CI:0.55 to 0.97,P=0.03)and anastomotic stenosis(OR=0.31,95%CI:0.16 to 0.62,P=0.0009)compared with HL.The risk of postoperative urinary dysfunction,however,did not differ significantly between the two techniques.The meta-analysis also showed no significant differences between LL and HL in terms of anastomotic leakage,postoperative complications,total lymph nodes harvested,blood loss,operation time,tumor recurrence,mortality,5-year overall survival rate,or 5-year disease-free survival rate.CONCLUSION Since LL may result in better bowel function and a reduced rate of anastomotic stenosis following CRC surgeries,we suggest that LL be preferred over HL.

关 键 词：Low ligation High ligation Colorectal cancer Genitourinary function Defecatory function META-ANALYSIS 

分 类 号：R735.34[医药卫生—肿瘤]