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Abstract：
BACKGROUND: Marginal ulcer (MU) is a common complication of Roux-en-Y Gastric Bypass (RYGB). The primary goal of this meta-analysis was to identify potential risk factors for MU post-RYGB.
METHODS: A comprehensive literature search was conducted on four databases (PubMed, Embase, Web of Science, and the Cochrane Library) to identify articles published from inception to 23 May 2023 that reported risk factors linked to ulcer occurrence post-RYGB. Hazard Ratio (HR) and Odds Ratio (OR) with respective 95% CI were calculated to estimate the impact of selected risk factors on MU. The risk factors were evaluated through multivariate analyses. The estimated risk factors were subjected to a random-effects model. Subgroup analysis based on study baseline characteristics and leave-one-out sensitivity analysis were also performed to investigate the potential sources of heterogeneity and assess the robustness of the findings.
RESULTS: Herein, 14 observational studies involving 77 250 patients were included. Diabetes, smoking, and steroid use were identified to be risk factors of MU, with pooled ORs of (1.812; 95% CI: 1.226-2.676; P =0.003), (3.491; 95% CI: 2.204-5.531; P< 0.001), and (2.804; 95% CI: 1.383-5.685; P =0.004), respectively. Other risk factors, such as alcohol consumption, male sex, and PPI use, were deemed not significant due to differences in data acquisition and effect estimates.
CONCLUSIONS: Diabetes, smoking, and steroid use were identified as independent risk factors of MU. Enhancing awareness of these identified risk factors will lead to more effective preoperative prevention and targeted postoperative interventions for patients undergoing RYGB.
METHODS: A comprehensive literature search was conducted on four databases (PubMed, Embase, Web of Science, and the Cochrane Library) to identify articles published from inception to 23 May 2023 that reported risk factors linked to ulcer occurrence post-RYGB. Hazard Ratio (HR) and Odds Ratio (OR) with respective 95% CI were calculated to estimate the impact of selected risk factors on MU. The risk factors were evaluated through multivariate analyses. The estimated risk factors were subjected to a random-effects model. Subgroup analysis based on study baseline characteristics and leave-one-out sensitivity analysis were also performed to investigate the potential sources of heterogeneity and assess the robustness of the findings.
RESULTS: Herein, 14 observational studies involving 77 250 patients were included. Diabetes, smoking, and steroid use were identified to be risk factors of MU, with pooled ORs of (1.812; 95% CI: 1.226-2.676; P =0.003), (3.491; 95% CI: 2.204-5.531; P< 0.001), and (2.804; 95% CI: 1.383-5.685; P =0.004), respectively. Other risk factors, such as alcohol consumption, male sex, and PPI use, were deemed not significant due to differences in data acquisition and effect estimates.
CONCLUSIONS: Diabetes, smoking, and steroid use were identified as independent risk factors of MU. Enhancing awareness of these identified risk factors will lead to more effective preoperative prevention and targeted postoperative interventions for patients undergoing RYGB.
摘要：
背景：边缘溃疡（MU）是Roux-en-Y胃旁路术（RYGB）的常见并发症。这项荟萃分析的主要目的是确定MU后RYGB的潜在危险因素。
方法：在四个数据库上进行了全面的文献检索（PubMed，Embase,WebofScience,和Cochrane图书馆），以确定从开始到2023年5月23日发表的文章，这些文章报告了与RYGB后溃疡发生相关的危险因素。计算风险比（HR）和赔率比（OR）以及各自的95％CI，以估计选定的风险因素对MU的影响。通过多变量分析评估危险因素。对估计的风险因素进行随机效应模型。还进行了基于研究基线特征的亚组分析和留一敏感性分析，以调查异质性的潜在来源并评估结果的稳健性。
结果：这里，包括14项涉及77.250名患者的观察性研究。糖尿病,吸烟,类固醇的使用被确定为MU的危险因素，合并OR为（1.812；95%CI：1.226-2.676；P=0.003），（3.491；95%CI：2.204-5.531；P<0.001），和（2.804；95%CI：1.383-5.685；P=0.004），分别。其他风险因素，比如饮酒，男性,和PPI的使用，由于数据采集和效果估计的差异，被认为不显著。
结论：糖尿病，吸烟,和类固醇使用被确定为MU的独立危险因素。增强对这些确定的危险因素的认识将导致对接受RYGB的患者进行更有效的术前预防和有针对性的术后干预。
方法：在四个数据库上进行了全面的文献检索（PubMed，Embase,WebofScience,和Cochrane图书馆），以确定从开始到2023年5月23日发表的文章，这些文章报告了与RYGB后溃疡发生相关的危险因素。计算风险比（HR）和赔率比（OR）以及各自的95％CI，以估计选定的风险因素对MU的影响。通过多变量分析评估危险因素。对估计的风险因素进行随机效应模型。还进行了基于研究基线特征的亚组分析和留一敏感性分析，以调查异质性的潜在来源并评估结果的稳健性。
结果：这里，包括14项涉及77.250名患者的观察性研究。糖尿病,吸烟,类固醇的使用被确定为MU的危险因素，合并OR为（1.812；95%CI：1.226-2.676；P=0.003），（3.491；95%CI：2.204-5.531；P<0.001），和（2.804；95%CI：1.383-5.685；P=0.004），分别。其他风险因素，比如饮酒，男性,和PPI的使用，由于数据采集和效果估计的差异，被认为不显著。
结论：糖尿病，吸烟,和类固醇使用被确定为MU的独立危险因素。增强对这些确定的危险因素的认识将导致对接受RYGB的患者进行更有效的术前预防和有针对性的术后干预。
