M Yu, Y Liu, N Li, J Xu, H Zhang, F Li, H Chen, B Li
{"title":"低位前切除术综合征的最佳干预措施：随机对照试验的贝叶斯网络荟萃分析。","authors":"M Yu, Y Liu, N Li, J Xu, H Zhang, F Li, H Chen, B Li","doi":"10.1007/s10151-024-03099-8","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>The optimal intervention for managing low anterior resection syndrome (LARS) remains uncertain. This Bayesian network meta-analysis was conducted to compare and rank the effectiveness of various interventions on LARS.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) addressing interventions for LARS were extracted from six electronic databases until September 2023. A network meta-analysis was performed using a Bayesian random-effects and consistency model. The results were presented as mean differences (MDs) with credible interval (CrI) or standardized mean differences (SMDs) with CrI.</p><p><strong>Results: </strong>A total of 11 RCTs were included. In the short term (≤ 6 months), transanal irrigation (TAI) had significant positive impacts on overall LARS symptoms (MD (95% CrI) -14.13 (-20.11, -7.83)) and the severity of bowel incontinence (SMD (95% CrI) -1.34 (-1.97, -0.71)) compared with the control group. Pelvic floor rehabilitation (PFR) also exhibited significant improvements in bowel incontinence as compared with the control group (SMD (95% CrI) -0.56 (-0.88, -0.23)). TAI was ranked highest for reducing LARS symptoms, followed by PFR, and percutaneous tibial nerve stimulation (PTNS). In the long term (> 6 months), the results indicated that TAI was most likely to rank first, followed by PTNS, and PFR; however, no significant differences were observed.</p><p><strong>Conclusions: </strong>In the short term, TAI was identified as the most effective treatment for managing LARS, followed by PFR. Both TAI and PTNS demonstrated promising potential in enhancing bowel function over the long term. Further trials are needed to confirm these findings.</p>","PeriodicalId":51192,"journal":{"name":"Techniques in Coloproctology","volume":"29 1","pages":"64"},"PeriodicalIF":2.9000,"publicationDate":"2025-02-13","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825619/pdf/","citationCount":"0","resultStr":"{\"title\":\"Optimal interventions for low anterior resection syndrome: Bayesian network meta-analysis of randomized controlled trials.\",\"authors\":\"M Yu, Y Liu, N Li, J Xu, H Zhang, F Li, H Chen, B Li\",\"doi\":\"10.1007/s10151-024-03099-8\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>The optimal intervention for managing low anterior resection syndrome (LARS) remains uncertain. This Bayesian network meta-analysis was conducted to compare and rank the effectiveness of various interventions on LARS.</p><p><strong>Methods: </strong>Randomized controlled trials (RCTs) addressing interventions for LARS were extracted from six electronic databases until September 2023. A network meta-analysis was performed using a Bayesian random-effects and consistency model. The results were presented as mean differences (MDs) with credible interval (CrI) or standardized mean differences (SMDs) with CrI.</p><p><strong>Results: </strong>A total of 11 RCTs were included. In the short term (≤ 6 months), transanal irrigation (TAI) had significant positive impacts on overall LARS symptoms (MD (95% CrI) -14.13 (-20.11, -7.83)) and the severity of bowel incontinence (SMD (95% CrI) -1.34 (-1.97, -0.71)) compared with the control group. Pelvic floor rehabilitation (PFR) also exhibited significant improvements in bowel incontinence as compared with the control group (SMD (95% CrI) -0.56 (-0.88, -0.23)). TAI was ranked highest for reducing LARS symptoms, followed by PFR, and percutaneous tibial nerve stimulation (PTNS). In the long term (> 6 months), the results indicated that TAI was most likely to rank first, followed by PTNS, and PFR; however, no significant differences were observed.</p><p><strong>Conclusions: </strong>In the short term, TAI was identified as the most effective treatment for managing LARS, followed by PFR. Both TAI and PTNS demonstrated promising potential in enhancing bowel function over the long term. Further trials are needed to confirm these findings.</p>\",\"PeriodicalId\":51192,\"journal\":{\"name\":\"Techniques in Coloproctology\",\"volume\":\"29 1\",\"pages\":\"64\"},\"PeriodicalIF\":2.9000,\"publicationDate\":\"2025-02-13\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC11825619/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Techniques in Coloproctology\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1007/s10151-024-03099-8\",\"RegionNum\":3,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"GASTROENTEROLOGY & HEPATOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Techniques in Coloproctology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1007/s10151-024-03099-8","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"GASTROENTEROLOGY & HEPATOLOGY","Score":null,"Total":0}
Optimal interventions for low anterior resection syndrome: Bayesian network meta-analysis of randomized controlled trials.
Background: The optimal intervention for managing low anterior resection syndrome (LARS) remains uncertain. This Bayesian network meta-analysis was conducted to compare and rank the effectiveness of various interventions on LARS.
Methods: Randomized controlled trials (RCTs) addressing interventions for LARS were extracted from six electronic databases until September 2023. A network meta-analysis was performed using a Bayesian random-effects and consistency model. The results were presented as mean differences (MDs) with credible interval (CrI) or standardized mean differences (SMDs) with CrI.
Results: A total of 11 RCTs were included. In the short term (≤ 6 months), transanal irrigation (TAI) had significant positive impacts on overall LARS symptoms (MD (95% CrI) -14.13 (-20.11, -7.83)) and the severity of bowel incontinence (SMD (95% CrI) -1.34 (-1.97, -0.71)) compared with the control group. Pelvic floor rehabilitation (PFR) also exhibited significant improvements in bowel incontinence as compared with the control group (SMD (95% CrI) -0.56 (-0.88, -0.23)). TAI was ranked highest for reducing LARS symptoms, followed by PFR, and percutaneous tibial nerve stimulation (PTNS). In the long term (> 6 months), the results indicated that TAI was most likely to rank first, followed by PTNS, and PFR; however, no significant differences were observed.
Conclusions: In the short term, TAI was identified as the most effective treatment for managing LARS, followed by PFR. Both TAI and PTNS demonstrated promising potential in enhancing bowel function over the long term. Further trials are needed to confirm these findings.
期刊介绍：
Techniques in Coloproctology is an international journal fully devoted to diagnostic and operative procedures carried out in the management of colorectal diseases. Imaging, clinical physiology, laparoscopy, open abdominal surgery and proctoperineology are the main topics covered by the journal. Reviews, original articles, technical notes and short communications with many detailed illustrations render this publication indispensable for coloproctologists and related specialists. Both surgeons and gastroenterologists are represented on the distinguished Editorial Board, together with pathologists, radiologists and basic scientists from all over the world. The journal is strongly recommended to those who wish to be updated on recent developments in the field, and improve the standards of their work.
Manuscripts submitted for publication must contain a statement to the effect that all human studies have been reviewed by the appropriate ethics committee and have therefore been performed in accordance with the ethical standards laid down in an appropriate version of the 1965 Declaration of Helsinki. It should also be stated clearly in the text that all persons gave their informed consent prior to their inclusion in the study. Details that might disclose the identity of the subjects under study should be omitted. Reports of animal experiments must state that the Principles of Laboratory Animal Care (NIH publication no. 86-23 revised 1985) were followed as were applicable national laws (e.g. the current version of the German Law on the Protection of Animals). The Editor-in-Chief reserves the right to reject manuscripts that do not comply with the above-mentioned requirements. Authors will be held responsible for false statements or for failure to fulfill such requirements.
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