Clinical efficacy of leal loop colostomy surgery vs colostomy in sigmoid colon cancer and rectal cancer: A Meta-analysis

Abstract

Objective The meta-analysis method was used to systematically evaluate the efficacy and safety of domestic colostomy and ileostomy for elderly patients with sigmoid colon cancer and rectal cancer. Methods Use computer to search China Knowledge Network, Wanfang Data Knowledge Service Platform, Weipu Journal Resource Integration Service Platform, China Biomedical Literature Database, collect patients with sigmoid colon cancer and rectal cancer for stageⅠresection and intestinal stoma, stage Ⅱ for intestinal Literature for oral closure. The search time limit is from the establishment of the library to April 2017. Inclusion and exclusion criteria were developed, relevant literature was searched, risk of bias was assessed, data from the included literature was finally extracted, and Meta analysis was performed using RevMan 5.3 software. Results There were 13 articles in this study, 926 patients underwent stage Ⅰ tumor resection and enterostomy, and stageⅡclosed for enterostomy. The meta-analysis showed that the ileal fistula group was discharged after the first stage. Time (MD=-1.87, 95%CI: -2.20~-1.54, P<0.00001), postoperative fasting time (MD=-2.11, 95%CI: -2.28~-1.94, P<0.00001), one postoperative hospital stay (MD=-0.53, 95%CI: -0.97~-0.10, P=0.02), postoperative complication rate (OR=0.55, 95%CI: 0.32~0.97, P=0.04), second-stage operation time (MD=-1.04, 95%CI: -1.22~-0.86; P<0.00001), second-stage postoperative exhaust time (MD=-1.67, 95%CI: -1.89~-1.45; P<0.00001), postoperative fasting time (MD=-1.67, 95%CI: -1.90~-1.44; P<0.00001), postoperative hospital stay (MD=-2.19, 95%CI: -2.58~-1.79; P<0.00001), the second-stage postoperative complication rate (OR=0.19, 95%CI: 0.11~0.33; P<0.00001) was significantly different from the colostomy group. The time of operation (MD=0.04, 95%CI: -0.03~0.11; P=0.25) was not statistically significant. Conclusion Ileal loop colostomy surgery is better than colostomy in terms of operation time, recovery time of gastrointestinal function , complication rate and hospital stay. Key words: Sigmoid colon neoplasms; Rectal neoplasms; Ileal loop colostomy; Colostomy; Meta-analysis