METHODS: Relevant articles were systematically searched on the PubMed, Embase, and Cochrane Library. The quality of included studies was evaluated using the Cochrane Handbook. A meta-analysis was conducted to assess the surgical outcomes and oncological outcomes by RevMan 5.4 software.
RESULTS: Fifteen studies with a total of 5054 patients, including 2432 patients with LCA preservation and 2622 patients without LCA preservation, were included and analyzed in this study. The meta-analysis revealed that preserving LCA in radical surgery of sigmoid and rectal cancer has lower anastomotic leakage incidence (OR = 1.03, 95% confidence interval = 0.83-1.27, P < .0001). There were no significant differences in the operative time, intraoperative blood loss, number of dissected lymph nodes, postoperative complications as well as the oncological outcomes including systemic recurrence, local recurrence, 5-year overall survival rate, and 5-year disease-free survival rate.
UNASSIGNED: This pooled analysis showed that preserving the LCA is safe and feasible in radical sigmoid and rectal cancer surgery.
方法:在PubMed上系统地搜索了相关文章,Embase,科克伦图书馆使用Cochrane手册评估纳入研究的质量。通过RevMan5.4软件进行荟萃分析以评估手术结果和肿瘤结果。
结果:15项研究,共5054名患者,包括2432例保留LCA的患者和2622例未保留LCA的患者,被纳入本研究并进行了分析。荟萃分析显示,乙状结肠和直肠癌根治术中保留LCA的吻合口漏发生率较低(OR=1.03,95%置信区间=0.83-1.27,P<0.0001)。手术时间无显著差异,术中失血,解剖的淋巴结数量,术后并发症以及包括全身复发在内的肿瘤学结果,局部复发,5年总生存率,5年无病生存率。
■该汇总分析表明,保留LCA在乙状结肠癌和直肠癌根治术中是安全可行的。