Surgical effect of laparoscopic anterior resection of rectal carcinoma with high ligate or low ligate inferior mesenteric artery: A Meta-analysis
10.3760/cma.j.issn.1673-4203.2017.12.013
- VernacularTitle:肠系膜下动位的高位结扎与低位结扎对腹腔镜直肠癌前切除术手术效果影响的Meta分析
- Author:
Jiankai SHEN
1
;
Zhanwu JIANG
;
Jie AN
;
Meifeng HE
;
Zhenjie MA
Author Information
1. 承德医学院
- Keywords:
Anastomotic leak;
Lymph node excision;
Meta-analysis;
Laparoscopic anterior resection of rectal;
Left colic artery
- From:
International Journal of Surgery
2017;44(12):841-847
- CountryChina
- Language:Chinese
-
Abstract:
Objective To evaluate the surgical effect of laparoscopic anterior resection of rectal carcinoma with or without the left colic artery.Methods Through computer searching PubMed,Cochrane Library,Embase,WanFang Date and CNIK Date.Handsearching the Gray literature simultaneously.The randomized controlled trails and clinical controlled trials comparing low ligation with high ligation the inferior mesenteric artery in laparoscopic anterior resection of rectal carcinoma were colected.Data were screened,extracted and evaluated by two reviewers independently.Meta-analyses were conducted using the sofeware STATE12.0.The standardized mean difference were calculated for continuous data and odds ratio for dichotomous and the point estimates of each effect quantity and 95％ confidence interval were calculated.TheI2 test was used to test the heterogeneity of the inchuded literature:if the heterogeneity was small,the fixed effects model was adopted.otherwise,the random effects models was adopted and explored the heterogeneity by sensitivity analysis or subgroup analysis.Results Forteen articles including 15 researches were met the selection criteria.The Meta-analyses showed that the grope of low ligation had lower rate of anastomotic fistula (OR =0.394,95 ％ CI:0.251-0.616,P =0.000) and longer opration time (SMD =0.361,95％CI:0.242-0.480,P =0.000).There is no statistical differences in the number of lymph node dissection besides the root of IMA (SMD =-0.017,95％ CI:-0.130-0.097,P =0.772) intraoperative biood loss (SMD =0.083,95 ％ CI:-0.048-0.214,P =0.213).Conclusions In spite of reserved the left colic artery had longer operation time it can reducedrate of anastomotic fistula effectively and there is no statistical differences in the number of lymph node dissection besides the root of IMA,intraoperative blood loss.It is possible to promote the use of reserved the left colic artery in laparoscopic anterior resection of rectal carcinoma.
