使用人工补片进行食管裂孔重建的随机对照实验的Meta分析

目的通过Meta分析对使用人工补片进行食管裂孔重建的效果和安全性进行评价。方法检索Pubmed和Cochrane数据库2007年4月10日以前有关使用人工补片进行食管裂孔重建的随机对照实验,使用Cochrane图书馆提供的Review Manager4.2软件对入选实验的数据进行合并分析。主要评价指标包括术后裂孔疝发生率和由补片引起的脏器磨损。结果有7项随机对照实验,其中3项实验满足纳入标准和排除标准而入选Meta分析。共有280名研究对象纳入分析,其中使用人工补片进行裂孔重建的患者(n=137)在随访期内有8例(5.83%)发生裂孔疝,对照组(n=143)有33例(23.08%)发生裂孔疝,相对危险度RR=0.30(95%CI,0.15-0.62,P=0.001),随访期内没有观察到因补片磨损引起的脏器损伤。结论使用人工补片进行裂孔重建明显降低术后近期裂孔疝的发生危险,具有良好的应用前景,但远期效果和安全性有待长期观察的结果进一步明确。

Meta analysis of randomized controlled trails on prosthetic hiatal repair

Purpose To evaluate the effect and safety of hiatal repair with prosthesis by meta analysis on published randomized controlled trails.Methods Pubmed and Cochrane library database were searched for randomized trails on prosthetic hiatal repair published before April 10,2007.A pooled data analysis of included trails was carried out.The primary outcome was post operation herniation and prosthesis erosion.Results There were 7 randomized controlled trails on prosthetic hiatal repaire with 3 of them including 280 patients altogether fulfilling the inclusion and exclusion criteria.During follow-up,hiatl hernia was observed in 8 patients(5.83%) in prosthesis group(n=137) and 33(23.08%) in non-prosthesis group(n=143).The relative risk for post operation herniation was 0.30(95% CI,0.15-0.62,P=0.001).No prosthesis erosion was observed in these 3 trails.Conclusions The use of prosthesis for hiatal repaire reduces the risk of short-term recurrence of post operation herniation.Further investigation about the long term effect and safety is required.