{"title":"急诊左结肠手术中无保护口一期吻合的安全性：一项荟萃分析。","authors":"Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang","doi":"10.1080/08941939.2025.2520992","DOIUrl":null,"url":null,"abstract":"<p><strong>Background: </strong>This study aims to evaluate the safety of primary anastomosis (PA) without a protective stoma in emergency left colon surgery.</p><p><strong>Methods: </strong>A systematic search was conducted in the PubMed, Web of Science, Embase, and Cochrane Library databases, covering articles from the inception of these databases until September 2024. The primary outcome was the incidence of anastomotic leakage.</p><p><strong>Results: </strong>The PA group exhibited a higher incidence of anastomotic leakage compared to the stoma surgery group (odds ratios (OR) = 5.86, <i>p</i> = 0.05). However, in cases of perforated diverticulitis (OR = 3.80, <i>p</i> = 0.19) and malignant obstruction (OR = 5.40, <i>p</i> = 0.23), the PA group did not show an increased risk of anastomotic leakage. In terms of other outcomes, the reoperation rate in the PA group was higher compared to the stoma surgery group (OR = 1.89, <i>p</i> < 0.001). However, there were no statistically significant differences in the mortality rate (OR = 1.04, <i>p</i> = 0.80) or the incidence of postoperative complications (OR = 1.50, <i>p</i> = 0.27) between the two groups.</p><p><strong>Conclusion: </strong>Primary anastomosis without a protective stoma is generally safe and can be considered a viable option in emergency left colon surgery.</p>","PeriodicalId":16200,"journal":{"name":"Journal of Investigative Surgery","volume":"38 1","pages":"2520992"},"PeriodicalIF":2.1000,"publicationDate":"2025-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis.\",\"authors\":\"Zhiyan Wang, Wentao Sheng, Senjie Dai, Xuanzhou Li, Guojian Lin, Xiaohong Kang\",\"doi\":\"10.1080/08941939.2025.2520992\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><strong>Background: </strong>This study aims to evaluate the safety of primary anastomosis (PA) without a protective stoma in emergency left colon surgery.</p><p><strong>Methods: </strong>A systematic search was conducted in the PubMed, Web of Science, Embase, and Cochrane Library databases, covering articles from the inception of these databases until September 2024. The primary outcome was the incidence of anastomotic leakage.</p><p><strong>Results: </strong>The PA group exhibited a higher incidence of anastomotic leakage compared to the stoma surgery group (odds ratios (OR) = 5.86, <i>p</i> = 0.05). However, in cases of perforated diverticulitis (OR = 3.80, <i>p</i> = 0.19) and malignant obstruction (OR = 5.40, <i>p</i> = 0.23), the PA group did not show an increased risk of anastomotic leakage. In terms of other outcomes, the reoperation rate in the PA group was higher compared to the stoma surgery group (OR = 1.89, <i>p</i> < 0.001). However, there were no statistically significant differences in the mortality rate (OR = 1.04, <i>p</i> = 0.80) or the incidence of postoperative complications (OR = 1.50, <i>p</i> = 0.27) between the two groups.</p><p><strong>Conclusion: </strong>Primary anastomosis without a protective stoma is generally safe and can be considered a viable option in emergency left colon surgery.</p>\",\"PeriodicalId\":16200,\"journal\":{\"name\":\"Journal of Investigative Surgery\",\"volume\":\"38 1\",\"pages\":\"2520992\"},\"PeriodicalIF\":2.1000,\"publicationDate\":\"2025-12-01\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"Journal of Investigative Surgery\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1080/08941939.2025.2520992\",\"RegionNum\":4,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/6/24 0:00:00\",\"PubModel\":\"Epub\",\"JCR\":\"Q2\",\"JCRName\":\"SURGERY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Investigative Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1080/08941939.2025.2520992","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/6/24 0:00:00","PubModel":"Epub","JCR":"Q2","JCRName":"SURGERY","Score":null,"Total":0}
引用次数: 0
摘要
背景：本研究旨在评价急诊左结肠手术中无保护性造口一期吻合（PA）的安全性。方法：系统检索PubMed、Web of Science、Embase和Cochrane图书馆数据库，涵盖从这些数据库建立到2024年9月的文章。主要观察结果为吻合口瘘发生率。结果：PA组吻合口漏发生率高于造口手术组(OR) = 5.86, p = 0.05)。然而，在穿孔性憩室炎（OR = 3.80, p = 0.19）和恶性梗阻（OR = 5.40, p = 0.23）的病例中，PA组没有显示吻合口瘘的风险增加。其他结果方面，PA组再手术率高于造口手术组（OR = 1.89, p = 0.80），两组术后并发症发生率高于造口手术组（OR = 1.50, p = 0.27）。结论：无保护性造口一期吻合是安全的，是急诊左结肠手术的可行选择。
The Safety of Primary Anastomosis Without Protective Stoma in Emergency Left Colon Surgery: A Meta-Analysis.
Background: This study aims to evaluate the safety of primary anastomosis (PA) without a protective stoma in emergency left colon surgery.
Methods: A systematic search was conducted in the PubMed, Web of Science, Embase, and Cochrane Library databases, covering articles from the inception of these databases until September 2024. The primary outcome was the incidence of anastomotic leakage.
Results: The PA group exhibited a higher incidence of anastomotic leakage compared to the stoma surgery group (odds ratios (OR) = 5.86, p = 0.05). However, in cases of perforated diverticulitis (OR = 3.80, p = 0.19) and malignant obstruction (OR = 5.40, p = 0.23), the PA group did not show an increased risk of anastomotic leakage. In terms of other outcomes, the reoperation rate in the PA group was higher compared to the stoma surgery group (OR = 1.89, p < 0.001). However, there were no statistically significant differences in the mortality rate (OR = 1.04, p = 0.80) or the incidence of postoperative complications (OR = 1.50, p = 0.27) between the two groups.
Conclusion: Primary anastomosis without a protective stoma is generally safe and can be considered a viable option in emergency left colon surgery.
期刊介绍：
Journal of Investigative Surgery publishes peer-reviewed scientific articles for the advancement of surgery, to the ultimate benefit of patient care and rehabilitation. It is the only journal that encompasses the individual and collaborative efforts of scientists in human and veterinary medicine, dentistry, basic and applied sciences, engineering, and law and ethics. The journal is dedicated to the publication of outstanding articles of interest to the surgical research community.
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