PDF(Pubmed)
Abstract：
UNASSIGNED: Increasing evidence shows that patients with Metabolic Syndrome (MetS) are at risk for adverse outcome after abdominal surgery. The aim of this study was to investigate the impact of MetS and preoperative hyperglycemia, as an individual component of MetS, on adverse outcome after colorectal surgery.
UNASSIGNED: A literature review was systematically performed according to the PRISMA guidelines. Inclusion criteria were observational studies that evaluated the relationship between MetS or preoperative hyperglycemia and outcomes after colorectal surgery (i.e. any complication, severe complication defined as Clavien-Dindo grade ≥ III, anastomotic leakage, surgical site infection, mortality and length of stay).
UNASSIGNED: Six studies (246.383 patients) evaluated MetS and eight studies (9.534 patients) reported on hyperglycemia. Incidence rates of MetS varied widely from 7% to 68% across studies. Meta-analysis showed that patients with MetS are more likely to develop severe complications than those without MetS (RR 1.62, 95% CI 1.01-2.59). Moreover, a non-significant trend toward increased risks for any complication (RR 1.35, 95% CI 0.91-2.00), anastomotic leakage (RR 1.67, 95% CI 0.47-5.93) and mortality (RR 1.19, 95% CI 1.00-1.43) was found. Furthermore, preoperative hyperglycemia was associated with an increased risk of surgical site infection (RR 1.35, 95% CI 1.01-1.81).
UNASSIGNED: MetS seem to have a negative impact on adverse outcome after colorectal surgery. As a result of few studies meeting inclusion criteria and substantial heterogeneity, evidence is not conclusive. Future prospective observational studies should improve the amount and quality in order to verify current results.
UNASSIGNED: A literature review was systematically performed according to the PRISMA guidelines. Inclusion criteria were observational studies that evaluated the relationship between MetS or preoperative hyperglycemia and outcomes after colorectal surgery (i.e. any complication, severe complication defined as Clavien-Dindo grade ≥ III, anastomotic leakage, surgical site infection, mortality and length of stay).
UNASSIGNED: Six studies (246.383 patients) evaluated MetS and eight studies (9.534 patients) reported on hyperglycemia. Incidence rates of MetS varied widely from 7% to 68% across studies. Meta-analysis showed that patients with MetS are more likely to develop severe complications than those without MetS (RR 1.62, 95% CI 1.01-2.59). Moreover, a non-significant trend toward increased risks for any complication (RR 1.35, 95% CI 0.91-2.00), anastomotic leakage (RR 1.67, 95% CI 0.47-5.93) and mortality (RR 1.19, 95% CI 1.00-1.43) was found. Furthermore, preoperative hyperglycemia was associated with an increased risk of surgical site infection (RR 1.35, 95% CI 1.01-1.81).
UNASSIGNED: MetS seem to have a negative impact on adverse outcome after colorectal surgery. As a result of few studies meeting inclusion criteria and substantial heterogeneity, evidence is not conclusive. Future prospective observational studies should improve the amount and quality in order to verify current results.
摘要：
■越来越多的证据表明，代谢综合征（MetS）患者在腹部手术后有不良结局的风险。这项研究的目的是探讨MetS和术前高血糖的影响，作为MetS的单独组成部分，结直肠手术后的不良结局。
■根据PRISMA指南系统地进行了文献综述。纳入标准是评估MetS或术前高血糖与结直肠手术后结局之间关系的观察性研究（即任何并发症，严重并发症定义为Clavien-Dindo等级≥III，吻合口漏,手术部位感染,死亡率和住院时间)。
■6项研究（246.383例患者）评估了MetS，8项研究（9.534例患者）报告了高血糖。在研究中，MetS的发病率差异很大，从7%到68%不等。Meta分析显示，与没有MetS的患者相比，MetS患者更容易发生严重并发症（RR1.62，95％CI1.01-2.59）。此外，任何并发症风险增加的趋势不显著(RR1.35，95%CI0.91-2.00)，发现吻合口漏(RR1.67,95%CI0.47-5.93)和死亡率(RR1.19,95%CI1.00-1.43)。此外，术前高血糖与手术部位感染风险增加相关(RR1.35,95%CI1.01-1.81).
■MetS似乎对结直肠手术后的不良结局有负面影响。由于很少有研究符合纳入标准和实质性异质性，证据不是决定性的。未来的前瞻性观察研究应提高数量和质量，以验证当前的结果。
■根据PRISMA指南系统地进行了文献综述。纳入标准是评估MetS或术前高血糖与结直肠手术后结局之间关系的观察性研究（即任何并发症，严重并发症定义为Clavien-Dindo等级≥III，吻合口漏,手术部位感染,死亡率和住院时间)。
■6项研究（246.383例患者）评估了MetS，8项研究（9.534例患者）报告了高血糖。在研究中，MetS的发病率差异很大，从7%到68%不等。Meta分析显示，与没有MetS的患者相比，MetS患者更容易发生严重并发症（RR1.62，95％CI1.01-2.59）。此外，任何并发症风险增加的趋势不显著(RR1.35，95%CI0.91-2.00)，发现吻合口漏(RR1.67,95%CI0.47-5.93)和死亡率(RR1.19,95%CI1.00-1.43)。此外，术前高血糖与手术部位感染风险增加相关(RR1.35,95%CI1.01-1.81).
■MetS似乎对结直肠手术后的不良结局有负面影响。由于很少有研究符合纳入标准和实质性异质性，证据不是决定性的。未来的前瞻性观察研究应提高数量和质量，以验证当前的结果。
