■大量研究已经热烈讨论肥胖是否是吻合口漏(AL)的危险因素,因为结直肠癌(CRC)病例的增加和肥胖患者CRC的高发病率。
■我们旨在探讨CRC术后内脏肥胖(VO)与AL的关系。Pubmed的数据库,Embase,和Cochrane图书馆搜索相关数据和文章发表到2022年11月1日。我们确定了有和没有VO的患者在CRC手术后AL发生率的差异。纳入研究的质量采用Newcastle-Ottawa量表进行评估,比值比(OR)和95%CI用于评估VO和AL之间的关联。
■这项荟萃分析包括7项研究,有2,136名患者。根据7项研究的固定效应模型,VO患者与无VO患者的OR为2.15(95CIs=1.46-3.15,异质性检验:P=0.29,I2=18%)。值得注意的是,两组间差异有统计学意义(Z=3.91P<0.0001)。结肠癌组VO患者的AL发生率较高(OR=2.88,95%CIs=1.38~5.99,异质性检验:P=0.27,I2=20%),高于直肠癌组(OR=2.74,95%CIs=1.13~6.65,异质性检验:P=0.20,I2=38%)。在相关文献的研究中,异质性较低。关于VO患者,4项亚洲研究报告与3项非亚洲研究相比,AL发病率增加(OR=2.79,95%CIs=1.35~5.78,异质性检验:P=0.35,I2=9%).
■我们的发现证实了VO和AL之间的显着关系。因此,VO可以被认为是结肠癌手术的可靠危险因素。
UNASSIGNED: Numberous studies have heatedly discussed whether obesity is a risk factor for anastomotic leakage (AL) because of the increasing number of colorectal cancer (CRC) cases and high incidence of CRC in patients with obesity.
UNASSIGNED: We aimed to explore the relationship between visceral obesity(VO) and AL after CRC surgery. The databases of Pubmed, Embase, and the Cochrane Library were searched for relevant data and articles published until November 1, 2022. We identified the difference in the incidence of AL after CRC surgery between patients with and without VO. The quality of included studies was evaluated using the Newcastle- Ottawa Scale, and odds ratio (OR) and 95% CI were used to assess the association between VO and AL.
UNASSIGNED: This meta-analysis included 7 studies with 2,136 patients. The OR of patients with VO versus those without VO was 2.15 (95%CIs = 1.46-3.15, test for heterogeneity: P = 0.29, I2 = 18%) based on the fixed-effect model in seven studies. Notably, the difference between the two groups was statistically significant (Z = 3.91 P < 0.0001). Patients with VO in the colon cancer group exhibited a higher incidence of AL (OR = 2.88, 95% CIs = 1.38-5.99, test for heterogeneity: P = 0.27, I2 = 20%) than those in the rectal cancer group (OR = 2.74, 95% CIs = 1.13-6.65, test for heterogeneity: P = 0.20, I2 = 38%). In the studies in the relevant literature, heterogeneity was low. Regarding patients with VO, four Asian studies reported increased morbidity due to AL (OR = 2.79, 95% CIs = 1.35-5.78, test for heterogeneity: P = 0.35, I2 = 9%) compared with three non-Asian studies.
UNASSIGNED: Our findings confirmed the significant relationship between VO and AL. Thus, VO could be considered a reliable risk factor of surgery for colon cancer.