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目的评价全胃切除Roux-en-Y加空肠储袋吻合术的有效性及安全性,为进一步临床研究与循证临床实践提供参考依据。方法计算机检索有关Roux-en-Y加空肠储袋对比单纯Roux-en-Y的随机对照试验(RCT)资料,检索时间截至2010年10月。由2位研究者逐篇评价纳入研究的质量、交叉核对提取数据,并采用RevMan5.0软件进行数据处理。结果共纳入12篇RCT,共577例病人。Meta分析显示:与单纯Roux-en-Y相比,Roux-en-Y加空肠储袋有助于改善术后3个月和6个月的体重,提高术后1和2年的生活质量,降低术后3、6和12~15个月倾倒综合征发生率。另外,两者的手术死亡率、手术并发症发生率及手术时间的差异无统计学意义。结论 Roux-en-Y加空肠储袋与单纯Roux-en-Y吻合术相比在术后近期内存在优势,而远期疗效仍须进一步研究证实。
Objective To evaluate the effectiveness and safety of total gastrectomy with Roux-en-Y plus jejunal pocket anastomosis to provide reference for further clinical research and evidence-based clinical practice. METHODS: Randomized controlled trials (RCTs) on Roux-en-Y plus Roux-en-Y versus jejunal pouch were searched by computer. The search time was up to October 2010. Two researchers evaluated the quality of the included studies cross-examine the data, and use RevMan5.0 software for data processing. Results A total of 12 RCTs were enrolled and 577 patients were included. Meta-analysis showed Roux-en-Y plus jejunal pouches could improve body weight at 3 months and 6 months postoperatively and improve quality of life 1 and 2 years after operation compared with Roux-en-Y alone, Reduce the incidence of dumping syndrome 3,6 and 12 to 15 months after surgery. In addition, there was no significant difference in operative mortality, incidence of complications and operation time between the two groups. Conclusions The Roux-en-Y plus jejunum pouch has advantages in the short-term after operation compared with Roux-en-Y anastomosis only, but the long-term efficacy still needs further study.