A Meta-analysis Of The Tube Stoma And Loop Stoma For Colorectal Surgery

Objective: To compare the effect of tube stoma with loop stoma in colorectal surgery by meta-analysis.Methods: According to the content of the study,the key words were selected and all the relevant literatures about the comparative study of tube and loop ostomy in colorectal surgery were searched from such as PubMed,EMBASE,Cochrane Library,CNKI and Wanfang electronic databases,and the qualified literatures were selected according to inclusion and exclusion criteria.Evaluate the quality of literatures,select high-quality literatures,and extract the target data from them.Finally,Review Manager 5.3 software was used for meta-analysis to evaluate the incidence of anastomotic leakage,reoperation rate for anastomotic leakage,stoma-related complications,operation time and hospital stay.Results: 12 articles were included in the study,with a total of 1232 subjects.Tube stoma was associated with less stoma-related complications(OR = 0.37,95%CI: 0.25-0.55,P < 0.00001),but there was no significant difference in the incidence of anastomotic leakage and the rate of reoperation for anastomotic leakage compared with traditional loop stoma(OR = 0.79,95% CI: 0.48 ~ 1.30,P = 0.35).OR = 1.76,95% CI: 0.56 ~ 5.54,P = 0.33).There was no significant difference in operation time between the two groups(MD =-13.22,95% CI:-42.68 ~ 16.23,P = 0.38).The total length of hospital stay of patients undergoing traditional ostomy was significantly longer than that of patients undergoing tube stoma(MD =-10.27,95% CI:-11.59 ~-8.95,P < 0.00001).Conclusion: Tube stoma in the colorectal surgery can play a role for the protection of the anastomotic.The effectiveness of this operation is equivalent to loop stoma.Meanwhile,it can avoid the complications related to stoma,such as hernia and prolapse of stoma.Without operation,the stoma can be removed and the quality of life of patients after operation can be improved.It is a safe and effective way of ostomy.