A Meta-analysis Of The Safety And Effectiveness Of Prophylaxis Of Stoma Complications By Using A Stoma Rod

Objective:To study the effect of the application of the stoma rod in the enterostomy on the incidence of postoperative stoma complications by meta analysis.Methods:A search of PUBMED,EMBASE,Cochrane library,VIP,Wanfang and CNKI for randomized controlled trials(RCTs)and Cohorts of support rod used in enterostomy was undertaken,from the date of January 2000 to July 2017.Eliminating duplicate studies,then screening literature with the title and abstract,further screening the full text of all eligible literatures,conducted all randomized controlled trials(RCTs)and cohort studies.Extraction of selected literature data.Consulted the cirteria of the Cochrane Handbook,quality of the included studies was evaluated and related data was extracted.RevMan5.3 software is used for statistical analysis to test heterogeneity and to select the corresponding effect model according to heterogeneity.Finally,the Jadad system was used to evaluate the quality of evidence.Result:According to the screening criteria,378 articles were screened and 1131 cases of enterostomy were selected in 6 literature.There were 569 cases in the experimental group and 562 cases in the control group.All of the 6 studies analysis the effect of stoma rod on the incidence of stoma retraction.The results of meta analysis showed that there were 32 cases of stoma retraction in the total 1131 cases,the total incidence was about2.8%,the incidence of rod group was about 2.3%,the rodless group was about 3.4%,and the incidence of retraction in the rod group was not significantly lower than that in the rodless group,the differences were not statistically significant(RR=0.66,95%CI:0.34-1.29,I~2=0%,P=0.23),It was in homogeneity(I~2=0).The incidence of other complications in the rod group such as dermatitis(RR=2.11,95%CI:1.61-2.76,I~2=0%,P<0.00001)、necrotic mucosa(RR=5.79,95%CI:2.04-16.44,I~2=0%,P=0.001)、separation of skin and mucous(RR=2.06,95%CI:1.02-4.15,I~2=0%,P=0.04)、skin irritation(P=0.006)increased significantly.Conclusion:There is no evidence that stoma rod has significant significance in preventing or reducing stoma contraction,and its application brings more stoma related complications to patients.The stoma rod is not recommended to be used in future clinical practice.