- 作者：H.S. Snijders ; M.W.J.M. Wouters ; N.J. van Leersum ; N.E. Kolfschoten ; D. Henneman ; A.C. de Vries ; R.A.E.M. Tollenaar ; B.A. Bonsing
- 关键词：Anastomotic leakage ; Complications ; Surgery ; Rectal cancer ; Mortality ; Low anterior resection
- 刊名：European Journal of Surgical Oncology (EJSO)
- 出版年：2012
- 出版时间：November, 2012
- 年：2012
- 卷：38
- 期：11
- 页码：1013-1019
- 全文大小：335 K
Background
Availability of anastomotic leakage rates and mortality rates following anastomotic leakage is essential when informing patients with rectal cancer preoperatively. We performed a meta-analysis of studies describing anastomotic leakage and the subsequent postoperative mortality in relation to the overall postoperative mortality after low anterior resection for rectal cancer.Methods
A systematic search was performed of the published literature. Data on the definition and incidence rate of AL, postoperative mortality caused by AL, and overall postoperative mortality were extracted. Data were pooled and a meta-analysis was performed.
Results
Twenty-two studies with 10,343 patients in total were analyzed. Meta-analysis of the data showed an average AL rate of 9 % , postoperative mortality caused by leakage of 0.7 % and overall postoperative mortality of 2 % . The studies showed variation in incidence, definition and measurement of all outcomes.
Conclusion
We found a considerable overall AL rate and a large contribution of AL to the overall postoperative mortality. The variability of definitions and measurement of AL, postoperative mortality caused by leakage and overall postoperative mortality may hinder providing reliable risk information. Large-scale audit programs may provide accurate and valid risk information which can be used for preoperative decision making.