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首页> 外文期刊>Surgical Endoscopy >Internal hernia after laparoscopic colorectal surgery: an under-reported potentially severe complication. A systematic review and meta-analysis
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Internal hernia after laparoscopic colorectal surgery: an under-reported potentially severe complication. A systematic review and meta-analysis

机译：腹腔镜结肠直肠手术后内部疝气：欠报告的潜在严重的并发症。 系统审查和荟萃分析

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BackgroundInternal hernia following laparoscopic colorectal surgery is often under-reported. The aim of this review was to evaluate the occurrence rate of internal hernia following laparoscopic colorectal surgery, and to describe clinical presentation and management strategies.MethodsA comprehensive literature review was conducted including MEDLINE/Pubmed, EMBASE, SCOPUS, clinicaltrials.gov, and the Cochrane Database of Systematic Reviews through April 2018. The review was conducted according to MOOSE guidelines. Quality was appraised with the Methodological Index for Non-Randomized Studies (MINORS) tool. Meta-analysis was performed using a random effects model. Studies reporting data on internal hernia after laparoscopic colorectal surgery were included.ResultsTen observational studies with a total of 8453 patients were included. All included articles were non-comparative prospective or retrospective cohort studies with an average MINORS score of 8.3 (range 6-11). Summary estimate of proportion of patients developing internal hernia after laparoscopic colorectal resection was 0.5% (95% CI 0.3-0.8%). Heterogeneity was moderate (I-2 46%, p=0.03) and study size (>1000 vs. <1000 patients) was found to have a significant contribution to heterogeneity (p=0.002). Thirty patients (90.9%) required surgery, with 5 non-fatal and 3 fatal postoperative complications. Quality of some studies was limited; some patients were followed up for less than 1year; primary surgical procedures included different laparoscopic approaches.ConclusionsOccurrence rate of internal hernia after laparoscopic colorectal resection is around 5 per 1000 patients. Small-sized studies are likely to overestimate the occurrence of internal hernia. Need for reoperation is high with a substantial risk of mortality.
机译：腹腔镜结直肠手术经常报道，腹腔镜结直肠手术疝气。本综述的目的是评估腹腔镜结直肠手术后内部疝的发生率，并描述临床介绍和管理策略。在进行综合文献和管理策略。在内进行了综合文献综述，包括Medline / Pubmed，Embase，Scopus，Clinicaltrials.gov和Cochrane 2018年4月的系统评价数据库。审查是根据莫斯指南进行的。质量评估了非随机研究（未成年人）工具的方法指标。使用随机效应模型进行META分析。包括腹腔镜结直肠手术后内部疝报告数据的研究。包括共有8453名患者的观察研究。所有包含的文章都是非比较的前瞻性或回顾性队列研究，平均未成年家得分为8.3（范围6-11）。概述腹腔镜结直肠切除后开发内部疝的比例的估计为0.5％（95％CI 0.3-0.8％）。发现异质性适度（I-2 46％，p = 0.03），并发现研究尺寸（> 1000与<1000名患者）对异质性具有显着贡献（p = 0.002）。三十名患者（90.9％）需要手术，5例非致命和3个致命的术后并发症。一些研究的质量有限;一些患者随访不到1年;初级外科手术包括不同的腹腔镜方法。腹腔镜结直肠切除后内部疝的结合率为每1000名患者约5例。小型研究可能会估量内部疝气的发生。需要重新进食，具有大量死亡风险。

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