METHODS: We searched for eligible studies in four databases including PubMed, Embase, Cochrane Library, and CNKI from inception to July 20, 2023. Both surgical outcomes and stoma-related complications were compared between the OM group and the traditional method (TM) group. The Newcastle-Ottawa Scale (NOS) was adopted for quality assessment. RevMan 5.4 was conducted for data analyzing.
RESULTS: Totally 590 patients from six studies were enrolled in this study (272 patients in the OM group and 318 patients in the TM group). No significant difference was found in baseline information (P > 0.05). Patients in the OM group had shorter operative time in both the primary LLAR surgery (MD = - 17.73, 95%CI = - 25.65 to - 9.80, P < 0.01) and the stoma reversal surgery (MD = - 18.70, 95%CI = - 22.48 to -14.92, P < 0.01) than patients in the TM group. There was no significant difference in intraoperative blood loss of the primary LLAR surgery (MD = - 2.92, 95%CI = - 7.15 to 1.32, P = 0.18). Moreover, patients in the OM group had fewer stoma-related complications than patients in the TM group (OR = 0.55, 95%CI = 0.38 to 0.79, P < 0.01).
CONCLUSIONS: The OM group had shorter operation time in both the primary LLAR surgery and the stoma reversal surgery than the TM group. Moreover, the OM group had less stoma-related complications.
方法:我们在包括PubMed、Embase,科克伦图书馆,和CNKI从成立到2023年7月20日。比较OM组和传统方法(TM)组的手术效果和造口相关并发症。采用纽卡斯尔-渥太华量表(NOS)进行质量评价。进行RevMan5.4的数据分析。
结果:这项研究共纳入了来自6项研究的590名患者(OM组272名患者,TM组318名患者)。两组基线资料比较差异无统计学意义(P>0.05)。OM组患者在初次LLAR手术(MD=-17.73,95CI=-25.65至-9.80,P<0.01)和造口逆转手术(MD=-18.70,95CI=-22.48至-14.92,P<0.01)中的手术时间均短于TM组。原发性LLAR手术的术中失血量差异无统计学意义(MD=-2.92,95CI=-7.15至1.32,P=0.18)。此外,OM组患者造口相关并发症少于TM组(OR=0.55,95CI=0.38~0.79,P<0.01)。
结论:OM组在初次LLAR手术和造口逆转手术中的手术时间均短于TM组。此外,OM组造口相关并发症较少。