PDF(Pubmed)
Abstract：
UNASSIGNED: Gangrenous sigmoid volvulus has a significant impact on morbidity and mortality. This study was conducted to compare sigmoid resection and primary anastomosis (RPA) with sigmoid resection and end colostomy (Hartmann\'s procedure) for gangrenous sigmoid volvulus.
UNASSIGNED: A systematic review and meta-analysis study design was employed to summarize retrospective cohort, prospective cohort, and randomised control trial studies published from inception to march 31, 2023. Searching was performed on Medline, CINAHAL, Web of Science, Google Scholar, the Cochrane Library, and ClinicalTrials.gov to locate eligible articles. Data searching, selection and screening, quality assessment of the included articles, and data extraction were done by two separate reviewers. RevMan 5.4 software with a fixed-effect Mantel-Haenszel model and Stata version 14 were used to analyze the data. The protocol registered on PROSPERO registration website (CRD42023413367).
UNASSIGNED: Ten cohort studies and one randomised control trial with 724 patients were found; all of them were rated as being of moderate quality. The overall mortality after RPA was 15% (95%CI: 11-19%), and after Hartmann\'s procedure it was 19% (95%CI: 15-23%). Resection and primary anastomosis (RPA) for gangrenous sigmoid volvulus had slightly lower mortality rate than stoma (OR=0.98(95%CI: 0.68-1.42), p=0.07, I2=43%), which had no statistically significant difference. Resection and primary anastomosis (RPA) had a slightly higher morbidity rate than Hartmann\'s procedure (OR=1.01(95%CI: 0.66-1.55), p=0.30, I2=18%), which had no statistically significant difference.
UNASSIGNED: Sigmoid resection and primary anastomosis (RPA) and Hartmann\'s procedure had no significant differences in mortality and morbidity for the treatment of gangrenous sigmoid volvulus. Choice of the intervention for gangrenous sigmoid volvulus should be individualized with consideration of different detrimental factors.
UNASSIGNED: A systematic review and meta-analysis study design was employed to summarize retrospective cohort, prospective cohort, and randomised control trial studies published from inception to march 31, 2023. Searching was performed on Medline, CINAHAL, Web of Science, Google Scholar, the Cochrane Library, and ClinicalTrials.gov to locate eligible articles. Data searching, selection and screening, quality assessment of the included articles, and data extraction were done by two separate reviewers. RevMan 5.4 software with a fixed-effect Mantel-Haenszel model and Stata version 14 were used to analyze the data. The protocol registered on PROSPERO registration website (CRD42023413367).
UNASSIGNED: Ten cohort studies and one randomised control trial with 724 patients were found; all of them were rated as being of moderate quality. The overall mortality after RPA was 15% (95%CI: 11-19%), and after Hartmann\'s procedure it was 19% (95%CI: 15-23%). Resection and primary anastomosis (RPA) for gangrenous sigmoid volvulus had slightly lower mortality rate than stoma (OR=0.98(95%CI: 0.68-1.42), p=0.07, I2=43%), which had no statistically significant difference. Resection and primary anastomosis (RPA) had a slightly higher morbidity rate than Hartmann\'s procedure (OR=1.01(95%CI: 0.66-1.55), p=0.30, I2=18%), which had no statistically significant difference.
UNASSIGNED: Sigmoid resection and primary anastomosis (RPA) and Hartmann\'s procedure had no significant differences in mortality and morbidity for the treatment of gangrenous sigmoid volvulus. Choice of the intervention for gangrenous sigmoid volvulus should be individualized with consideration of different detrimental factors.
摘要：
■乙状结肠扭转对发病率和死亡率有显著影响。本研究旨在比较乙状结肠切除术和原发性吻合术（RPA）与乙状结肠切除术和结肠末端造口术（Hartmann's程序）治疗坏疽性乙状结肠扭转。
■采用系统评价和荟萃分析研究设计来总结回顾性队列，前瞻性队列，以及从开始到2023年3月31日发表的随机对照试验研究。搜索是在Medline上进行的，CINAHAL,WebofScience,谷歌学者，Cochrane图书馆,和ClinicalTrials.gov找到符合条件的文章。数据搜索,选择和筛选，纳入文章的质量评估，数据提取由两名独立的审阅者完成。使用具有固定效应Mantel-Haenszel模型的RevMan5.4软件和Stata版本14对数据进行分析。在PROSPERO注册网站（CRD42023413367）上注册的协议。
■发现了10项队列研究和1项随机对照试验，共有724名患者；所有这些都被评为中等质量。RPA后的总死亡率为15％（95CI：11-19％），哈特曼手术后，这一比例为19%(95CI:15-23%)。坏疽性乙状结肠扭转切除和一期吻合（RPA）的死亡率略低于造口（OR=0.98（95CI：0.68-1.42），p=0.07，I2=43%），差异无统计学意义。切除和原发性吻合术（RPA）的发病率略高于Hartmann's手术（OR=1.01（95CI：0.66-1.55），p=0.30，I2=18%），差异无统计学意义。
■乙状结肠切除术和原发性吻合术（RPA）和Hartmann手术在坏疽性乙状结肠扭转的死亡率和发病率上没有显著差异。坏疽性乙状结肠扭转的干预措施的选择应考虑不同的有害因素。
■采用系统评价和荟萃分析研究设计来总结回顾性队列，前瞻性队列，以及从开始到2023年3月31日发表的随机对照试验研究。搜索是在Medline上进行的，CINAHAL,WebofScience,谷歌学者，Cochrane图书馆,和ClinicalTrials.gov找到符合条件的文章。数据搜索,选择和筛选，纳入文章的质量评估，数据提取由两名独立的审阅者完成。使用具有固定效应Mantel-Haenszel模型的RevMan5.4软件和Stata版本14对数据进行分析。在PROSPERO注册网站（CRD42023413367）上注册的协议。
■发现了10项队列研究和1项随机对照试验，共有724名患者；所有这些都被评为中等质量。RPA后的总死亡率为15％（95CI：11-19％），哈特曼手术后，这一比例为19%(95CI:15-23%)。坏疽性乙状结肠扭转切除和一期吻合（RPA）的死亡率略低于造口（OR=0.98（95CI：0.68-1.42），p=0.07，I2=43%），差异无统计学意义。切除和原发性吻合术（RPA）的发病率略高于Hartmann's手术（OR=1.01（95CI：0.66-1.55），p=0.30，I2=18%），差异无统计学意义。
■乙状结肠切除术和原发性吻合术（RPA）和Hartmann手术在坏疽性乙状结肠扭转的死亡率和发病率上没有显著差异。坏疽性乙状结肠扭转的干预措施的选择应考虑不同的有害因素。
