期刊论文详细信息
World Journal of Surgical Oncology
Comparison of the extraperitoneal and transperitoneal routes for permanent colostomy: a meta-analysis with RCTs and systematic review
Jinlong Luo1  Faqiang Zhang1  Hua Yang1  Huaiwu Jiang2  Xiaoying Zha3  Xinting Yang4  Dujanand Singh5  Lie Yang5 
[1]Department of Colorectal Anal Surgery, Zigong Fourth People’s Hospital
[2]Department of General Surgery, Sichuan Mianyang 404 Hospital
[3]Department of Wound Care Center, Department of Colorectal Anal Surgery, Zigong Fourth Hospital
[4]Department of Wound Care Center, West China Hospital
[5]Laboratory of Digestive Surgery, West China Hospital and State Key Laboratory of Biotherapy, Sichuan University
关键词: Meta-analysis;    Extraperitoneal;    Transperitoneal;    Colostomy;    Complication;    Parastomal hernia;   
DOI  :  10.1186/s12957-022-02547-9
来源: DOAJ
【 摘 要 】
Abstract Aim To assess the efficacy of extraperitoneal colostomy (EPC) in preventing stoma-related complications. Background Transperitoneal colostomy (TPC) is a widely used surgical approach. However, TPCs have been reported to have increased risks of stoma-related complications, such as parastomal hernias, stomal retraction, and stomal prolapse. The purpose of EPC is to reduce these complications. However, there is still a lack of evidence-based studies. Materials and methods MEDLINE, EMBASE, Web of Science, Scopus, MOOSE, PubMed, Google Scholar, Baidu Scholar, and the Cochrane Library were searched to conduct a systematic review and meta-analysis with RCTs. The meta-analysis was performed with RevMan 5.4 software. Results This study included 5 eligible RCTs. Compared with the TPC group, the EPC group had lower incidence rates of parastomal hernias (RR, 0.14; 95% CI, 0.04–0.52, P = 0.003, I 2 = 0%) and stomatal prolapse (RR, 0.27; 95% CI, 0.08–0.95, P = 0.04, I 2 = 0%), but a higher rate of defecation sensation (RR, 3.51; 95% CI, 2.47–5.0, P < 0.00001, I 2 = 37%). No statistically significant differences were observed in stoma retraction, colostomy construction time, stoma ischemia, or stoma necrosis. Conclusion Extraperitoneal colostomies are associated with lower rates of postoperative complications than transperitoneal colostomies. A randomized controlled trial meta-analysis found that permanent colostomies after abdominoperineal resection resulted in better outcomes.
【 授权许可】

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