Stefan Simeonovski, Karim Ataya, Tsonka Lukanova, Yusuf Ahmed, Dima Salloum, Ivelin Takorov
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引用次数: 0
摘要
背景：胃排空延迟（DGE）是左侧肝切除术（LSH）后常见的并发症。在LSH患者中使用网膜瓣（of）被认为可以减少DGE的发生率。因此，为了探索这些发现，进行了荟萃分析。方法：检索Pubmed， Embase和Cochrane Central，以比较LSH患者使用网膜瓣和不使用网膜瓣的研究。主要结局为DGE。采用Review Manager 5.4 （Cochrane Collaboration）进行统计分析。采用I2统计量评估异质性。使用随机效应模型计算二元终点的优势比（OR）。结果：7项研究共纳入358例患者，其中2项为随机对照试验（rct）。男性占多数（68%）。155例应用OF预防DGE。在3项研究中，大网膜被分开以准备皮瓣。Dge(或0.10；95% ci 0.04-0.23；p 2 = 0 %)和总发病率(OR 0.31；95% ci 0.13-0.74；p = 0.008；I2 = 0%)，与无OF组相比，OF组显著降低。讨论：与不使用大网膜皮瓣相比，在左侧肝切除术患者中使用大网膜皮瓣可显著降低DGE的发生率和总体发病率。
Use of omental flap in left-sided hepatectomy for prevention of delayed gastric emptying: a systematic review and meta-analysis.
Background: Delayed gastric emptying (DGE) is a widespread complication after left-sided hepatectomy (LSH). The usage of omental flap (OF) in patients after LSH is thought to reduce the incidence of DGE. Therefore, a meta-analysis was performed in order these findings to be explored.
Methods: Pubmed, Embase and Cochrane Central were searched for studies comparing usage of omental flap to no-OF in patients after LSH. The primary outcome was DGE. Statistical analysis was performed using Review Manager 5.4 (Cochrane Collaboration). Heterogeneity was assessed using I2 statistics. Odds ratios (OR) were computed for binary endpoints using a random-effects model.
Results: 358 patients were included from 7 studies, of which 2 were randomized controlled trials (RCTs). Male sex was predominant (68 %). OF was used for prevention of DGE in 155 cases. In 3 of the studies the greater omentum was divided for the preparation of the flap. DGE (OR 0.10; 95 % CI 0.04-0.23; p < 0.00001; I2 = 0 %) and overall morbidity (OR 0.31; 95 % CI 0.13-0.74; p = 0.008; I2 = 0 %) were significantly reduced in the OF group, compared to the no-OF group.
Discussion: Utilization of omental flap in patients with left-sided hepatectomy significantly reduces the incidence of DGE and overall morbidity, compared to the no-omental flap procedure.
期刊介绍：
Since its establishment in 2003, The Surgeon has established itself as one of the leading multidisciplinary surgical titles, both in print and online. The Surgeon is published for the worldwide surgical and dental communities. The goal of the Journal is to achieve wider national and international recognition, through a commitment to excellence in original research. In addition, both Colleges see the Journal as an important educational service, and consequently there is a particular focus on post-graduate development. Much of our educational role will continue to be achieved through publishing expanded review articles by leaders in their field.
Articles in related areas to surgery and dentistry, such as healthcare management and education, are also welcomed. We aim to educate, entertain, give insight into new surgical techniques and technology, and provide a forum for debate and discussion.
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