Systematic review of intraoperative colonic irrigation vs. manual decompression in obstructed left-sided colorectal emergencies
العنوان: | Systematic review of intraoperative colonic irrigation vs. manual decompression in obstructed left-sided colorectal emergencies |
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المؤلفون: | Edwin Sy Chan, Ming-Hian Kam, Jit-Fong Lim, Choong-Leong Tang, K. W. Eu |
المصدر: | International Journal of Colorectal Disease. 24:1031-1037 |
بيانات النشر: | Springer Science and Business Media LLC, 2009. |
سنة النشر: | 2009 |
مصطلحات موضوعية: | Leak, medicine.medical_specialty, Colon, Decompression, Therapeutic irrigation, Anastomosis, law.invention, Randomized controlled trial, law, Colon surgery, medicine, Humans, Therapeutic Irrigation, Digestive System Surgical Procedures, Clinical Trials as Topic, Intraoperative Care, business.industry, Mortality rate, Anastomosis, Surgical, Rectum, Gastroenterology, Decompression, Surgical, Surgery, Meta-analysis, Emergencies, business, Intestinal Obstruction |
الوصف: | A systematic review was conducted to determine if manual decompression is a safe alternative to intraoperative colonic irrigation prior to primary anastomosis in obstructed left-sided colorectal emergencies. Search for relevant articles from 1980 to 2007 was conducted on Medline, Embase and the Cochrane Controlled Trials Register using the keywords “colonic lavage, irrigation, decompression, washout, obstructed and bowel preparation”, either singularly or in combination. Trials in English publications with similar patient characteristics, inclusion criteria and outcome measures were selected for analysis. Thirty-day mortality, anastomotic leak rates and post-operative wound infection were studied as outcome variables. Analysis was performed with RevMan 4.2 software. Seven trials were identified for systematic review, with a total of 449 patients. Data from the single randomised controlled trial and one prospective comparative trial were analysed separately. Results from the remaining five studies were pooled into two arms of a composite series, one with colonic irrigation and one without. Results showed no significant difference in the anastomotic leak rates and mortality rates between the colonic irrigation and manual decompression arms in the randomised and comparative trials. The composite series, however, showed significantly better results with manual decompression (RR 6.18, 95% CI 1.67–22.86). The post-operative infection rate was similar in both groups. Manual decompression was comparable to colonic irrigation for primary anastomosis in obstructed left-sided colorectal emergencies, with no significant increase in mortality, leak or infection rates. |
تدمد: | 1432-1262 0179-1958 |
URL الوصول: | https://explore.openaire.eu/search/publication?articleId=doi_dedup___::b7b9214844f9882e24e661282c8acfaf https://doi.org/10.1007/s00384-009-0723-1 |
حقوق: | CLOSED |
رقم الأكسشن: | edsair.doi.dedup.....b7b9214844f9882e24e661282c8acfaf |
قاعدة البيانات: | OpenAIRE |
تدمد: | 14321262 01791958 |
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