肥胖患者Roux-en-Y胃旁路术中肠系膜缺损的闭合:一项系统回顾和荟萃分析方案

Rhys Thomas , Torsten Olbers , Jonathan D. Barry , Andrew J. Beamish
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引用次数: 2

摘要

腹腔镜Roux-en-Y胃旁路手术(RYGB)中肠系膜缺损的闭合尚未完全确立为标准的手术实践。然而,近年来出现的大量证据表明,不闭合缺损会增加内疝的发生率及其潜在后果,包括需要再次手术,以及相关的发病率和死亡率风险。在新出现的文献中,也有一些证据表明闭合组出现30天并发症的风险更高。本系统综述和荟萃分析旨在观察现有的证据,并为是否应将肠系膜缺损闭合作为标准手术实践提供指导。方法采用系统评价和荟萃分析方法。文献检索将通过Ovid查询Medline和Embase数据库,以及Cochrane对照试验注册(CENTRAL),以确定随机和非随机研究报告RYGB期间肠系膜缺陷闭合与非闭合后的比较结果。主要结局是小肠梗阻的再手术,次要结局包括内疝、空肠-空肠吻合狭窄或扭结、粘连、并发症(术后30 天和30 天)、30天死亡率、再手术和任何其他被认为相关并在不止一项研究中报告的结局。
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Closure of mesenteric defects during Roux-en-Y gastric bypass for obesity: A systematic review and meta-analysis protocol

Introduction

Closure of mesenteric defects during laparoscopic Roux-en-Y gastric bypass surgery (RYGB) has not been fully established as standard operative practice. However, in recent years a body of evidence has emerged suggesting that non-closure of defects leads to increased rates of internal herniation and its potential consequences, including the need for reoperation, along with an associated morbidity and mortality risk. Within the emerging literature there has also been some evidence of a greater risk of 30-day complications in closure groups. This systematic review and meta-analysis aims to look at the existing evidence and provide guidance on whether closure of mesenteric defects should be standard operative practice.

Methods

The systematic review and meta-analysis has been registered a priori. A literature search will be performed interrogating the Medline and Embase databases via Ovid, and also the Cochrane Controlled Register of Trials (CENTRAL), to identify randomised and non-randomised studies reporting comparative outcomes following closure vs. non-closure of mesenteric defects during RYGB. The primary outcome will be reoperation for small bowel obstruction, and secondary outcomes will include internal herniation, jejuno-jejunal anastomosis narrowing or kinking, adhesions, complications (<30 days and >30 days after surgery), 30-day mortality, reoperation, and any other outcome deemed relevant and reported in more than one study.

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期刊介绍: IJS Protocols is the first peer-reviewed, international, open access journal seeking to publish research protocols across across the full breadth of the surgical field. We are aim to provide rapid submission to decision times whilst maintaining a high quality peer-review process.
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