Abstract：
To further define the risk factors and incidence of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma.
Records from five English databases and four Chinese databases. Odds ratios (OR) and 95 % confidence intervals (CI) were used to indicate the risk of inclusion of risk factors. The non-closure stoma rate used the risk difference (RD) and 95 % CI. Risk factors were evaluated for quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Risk factors of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma were Age ≥60 years[OR:1.57, 95%CI(1.44,1.72)], Tumor IV stage[OR:4.21, 95%CI(2.29,7.74)], American Society of Anesthesiologists (ASA)≥3[OR:1.48, 95%CI(1.33,1.65)], Neoadjuvant chemoradiotherapy[OR:1.41, 95%CI(1.09,1.82)],Open surgery[OR:1.45, 95%CI(1.09,1.93)], Postoperative chemotherapy[OR:1.37, 95%CI(1.03,1.82)], Anastomotic leakage[OR:4.61, 95%CI(2.86, 7.44)], Local recurrence[OR:7.16, 95%CI(4.70, 10.91)]. The rate of non-closure stoma after anterior resection for rectal cancer was: 0.20, 95 % CI (0.17, 0.23). The quality of evidence for stage IV tumors and anastomotic leakage was moderate, and other risk factors were low to very low.
Risk factors of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma were Age≥60 years, Tumor IV stage, ASA≥3, Neoadjuvant chemoradiotherapy, Open surgery, Postoperative chemotherapy, Anastomotic leakage, Local recurrence, and one in five anterior resection patients with a temporary stoma fails to close.
Records from five English databases and four Chinese databases. Odds ratios (OR) and 95 % confidence intervals (CI) were used to indicate the risk of inclusion of risk factors. The non-closure stoma rate used the risk difference (RD) and 95 % CI. Risk factors were evaluated for quality of evidence using the Grading of Recommendations Assessment, Development and Evaluation (GRADE).
Risk factors of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma were Age ≥60 years[OR:1.57, 95%CI(1.44,1.72)], Tumor IV stage[OR:4.21, 95%CI(2.29,7.74)], American Society of Anesthesiologists (ASA)≥3[OR:1.48, 95%CI(1.33,1.65)], Neoadjuvant chemoradiotherapy[OR:1.41, 95%CI(1.09,1.82)],Open surgery[OR:1.45, 95%CI(1.09,1.93)], Postoperative chemotherapy[OR:1.37, 95%CI(1.03,1.82)], Anastomotic leakage[OR:4.61, 95%CI(2.86, 7.44)], Local recurrence[OR:7.16, 95%CI(4.70, 10.91)]. The rate of non-closure stoma after anterior resection for rectal cancer was: 0.20, 95 % CI (0.17, 0.23). The quality of evidence for stage IV tumors and anastomotic leakage was moderate, and other risk factors were low to very low.
Risk factors of non-closure stoma in patients with anterior resection of rectal cancer with temporary stoma were Age≥60 years, Tumor IV stage, ASA≥3, Neoadjuvant chemoradiotherapy, Open surgery, Postoperative chemotherapy, Anastomotic leakage, Local recurrence, and one in five anterior resection patients with a temporary stoma fails to close.
摘要：
背景：目的进一步明确直肠癌前切除术伴暂时性造口患者造口非闭合造口的危险因素和发生率。
方法：记录来自五个英文数据库和四个中文数据库。使用比值比（OR）和95％置信区间（CI）来指示纳入危险因素的风险。造口不闭合率采用风险差异(RD)和95%CI。使用建议分级评估对风险因素的证据质量进行评估，开发和评估（等级）。
结果：直肠癌前切除术伴暂时性造口患者造口未闭合的危险因素为年龄≥60岁[OR：1.57,95CI(1.44,1.72)]，肿瘤IV期[OR：4.21,95CI（2.29,7.74）]，美国麻醉医师协会（ASA）≥3[OR：1.48,95CI（1.33,1.65）]，新辅助放化疗[OR：1.41,95CI（1.09,1.82）]，开放手术[OR：1.45,95CI（1.09,1.93）]，术后化疗[OR：1.37,95CI（1.03,1.82）]，吻合口漏[OR:4.61,95CI(2.86,7.44)],局部复发[OR:7.16,95CI(4.70,10.91)]。直肠癌前切除术后未闭合造口的发生率为：0.20，95％CI（0.17，0.23）。IV期肿瘤和吻合口漏的证据质量中等，其他危险因素低至非常低。
结论：直肠癌前切除术合并临时造口患者造口未闭合的危险因素为年龄≥60岁，肿瘤IV期,ASA≥3，新辅助放化疗，开腹手术,术后化疗,吻合口漏,局部复发,五分之一的前切除术患者的临时造口无法关闭。
方法：记录来自五个英文数据库和四个中文数据库。使用比值比（OR）和95％置信区间（CI）来指示纳入危险因素的风险。造口不闭合率采用风险差异(RD)和95%CI。使用建议分级评估对风险因素的证据质量进行评估，开发和评估（等级）。
结果：直肠癌前切除术伴暂时性造口患者造口未闭合的危险因素为年龄≥60岁[OR：1.57,95CI(1.44,1.72)]，肿瘤IV期[OR：4.21,95CI（2.29,7.74）]，美国麻醉医师协会（ASA）≥3[OR：1.48,95CI（1.33,1.65）]，新辅助放化疗[OR：1.41,95CI（1.09,1.82）]，开放手术[OR：1.45,95CI（1.09,1.93）]，术后化疗[OR：1.37,95CI（1.03,1.82）]，吻合口漏[OR:4.61,95CI(2.86,7.44)],局部复发[OR:7.16,95CI(4.70,10.91)]。直肠癌前切除术后未闭合造口的发生率为：0.20，95％CI（0.17，0.23）。IV期肿瘤和吻合口漏的证据质量中等，其他危险因素低至非常低。
结论：直肠癌前切除术合并临时造口患者造口未闭合的危险因素为年龄≥60岁，肿瘤IV期,ASA≥3，新辅助放化疗，开腹手术,术后化疗,吻合口漏,局部复发,五分之一的前切除术患者的临时造口无法关闭。
