保留左结肠动脉对直肠癌腹腔镜根治术患者排尿和排便影响的meta分析  

The effect of preserving the left colon artery on urination and defecation in patients undergoing laparoscopic radical resection of rectal cancer:a meta-analysis

作　　者：金鑫[1] 黄勇[2] 刘维高 JIN Xin;HUANG Yong;LIU Weigao(Department of Surgery,Neijiang Fourth People′s Hospital/People′s Hospital of Dongxing District,Neijiang,Sichuan 641100,China;Department of Gastrointestinal Surgery,Guanghan Hospital of Sichuan Provincial People′s Hospital/Guanghan People′s Hospital,Guanghan,Sichuan 618300,China;ICU of Traditional Chinese Medicine Hospital of Neijiang,Neijiang,Sichuan 641100,China)

机构地区：[1]四川省内江市第四人民医院/四川省内江市东兴区人民医院外科,641100 [2]四川省人民医院广汉医院/四川省广汉市人民医院外科,618300 [3]四川省内江市中医医院ICU,641000

出　　处：《重庆医学》2021年第20期3536-3540,共5页Chongqing medicine

摘　　要：目的评价保留左结肠动脉(LAC)对直肠癌腹腔镜根治术患者排尿和排便功能的影响,以期为提高直肠癌患者术后生存和生活质量提供参考。方法检索PubMed、万方、中国知网、维普数据库,中华医学期刊网等,搜集以直肠癌患者腹腔镜结肠前切除/根治术为主题的相关研究。检索时限均为建库至2021年2月28日。采用RevMan 5.3软件进行meta分析。结果共检索到308篇相关文献,通过阅读标题及摘要初筛出81篇符合纳入排除标准,再通过阅读全文最终筛选出29篇。29项研究共3614例患者纳入研究。保留LCA组(LCA组)1787例,未保留LCA组(NLCA组)1827例。两组排尿功能异常:OR=0.12,95%CI:0.09~0.17,Z=13.78,P<0.00001;RR=0.20,95%CI:0.15~0.26,Z=11.95,P<0.00001;排便功能异常(OR=0.45,95%CI:0.34~0.61,Z=5.39,P<0.00001;RR=0.50,95%CI:0.39~0.65,Z=5.35,P<0.00001)比较,差异均有统计学意义。结论直肠癌腹腔镜根治术中,保留LCA患者排尿和排便异常发生风险较不保留LCA更低,能获得更好的生存和生活质量。Objective To evaluate the effect of preserving the left colon artery(LAC)on urination and defecation in patients undergoing laparoscopic radical resection of rectal cancer,in order to provide a reference for improving the survival and quality of life of patients with rectal cancer.Methods PubMed,WangFang,CNKI,VIP,and Chinese Medical Journal Network databases were searched to collect related researches on the subject of laparoscopic anterior colon resection radical resection for patients with rectal cancer.The search time limit was from the establishment of the database to February 28,2021.RevMan 5.3 software was used for meta-analysis.Results A total of 308 related articles were retrieved,81 articles were screened out through reading the titles and abstracts that met the inclusion criteria,and 29 articles were finally screened out by reading the full text.A total of 3614 patients from 29 studies were included in the study.There were 1787 cases in the LCA group and 1827 cases in the non-LCA group(NLCA group).Abnormal urination function(OR=0.12,95%CI:0.09-0.17,Z=13.78,P<0.00001;RR=0.20,95%CI:0.15-0.26,Z=11.95,P<0.00001),abnormal defecation function(OR=0.45,95%CI:0.34-0.61,Z=5.39,P<0.00001;RR=0.50,95%CI:0.39-0.65,Z=5.35,P<0.00001)were significantly different between the two groups.Conclusion During laparoscopic radical resection of rectal cancer,patients preserving the LCA have a lower risk of abnormal urination and defecation,and can achieve better survival and quality of life.

关 键 词：直肠癌 左结肠动脉 排尿异常 排便异常 META分析 

分 类 号：R563.1[医药卫生—呼吸系统]