中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
Chinese Journal of Gastrointestinal Surgery
2015年
11期
1144-1148
,共5页
许松欣%邓彬%陈姚生%丁岩冰%徐子山
許鬆訢%鄧彬%陳姚生%丁巖冰%徐子山
허송흔%산빈%진요생%정암빙%서자산
减肥手术%肥胖%发病风险%体质指数
減肥手術%肥胖%髮病風險%體質指數
감비수술%비반%발병풍험%체질지수
Bariatric surgery%Obesity%Risk%Body mass index(BMI)
目的 探讨减重手术能否降低肥胖患者的肥胖相关肿瘤发病率.方法 通过计算机检索PubMed、Medline、EBSCO、High Wire Press、OVID、EMbase、中国知网(CNKI)及万方数据库中自建库以来发表的有关比较减重手术与非手术减重患者的肥胖相关肿瘤发病率的文献.严格按照标准筛选后,评估文献质量并提取数据资料,采用Review manager5.2软件进行Meta分析,并进行敏感性分析,采用倒漏斗图检验发表偏倚.结果 5篇文献的108 954例患者纳入分析,其中减重手术组26 218例;对照组(非手术减重)82 736例.Meta分析结果显示:减重手术能够明显降低患者术后肥胖相关肿瘤的发生(RR=0.60,95％ CI:0.45～0.80,P=0.0005).亚组分析显示,减重治疗后,两组男性患者肥胖肿瘤的发病风险差异无统计学意义(P=0.74);而减重手术组女性患者术后发生肥胖相关肿瘤的概率明显低于对照组(RR=0.68, 95％ CI:0.61～0.77,P＜0.01).随访1～10年者,减重手术组的术后肥胖相关肿瘤发生率明显低于对照组(P＜0.05);而随访10年以上者,两组的肥胖相关肿瘤发生率差异无统计学意义(P=0.70).结论 减重手术可以降低肥胖相关性肿瘤的发病风险,尤其女性患者;但随着时间的延长,该作用不再显现.
目的 探討減重手術能否降低肥胖患者的肥胖相關腫瘤髮病率.方法 通過計算機檢索PubMed、Medline、EBSCO、High Wire Press、OVID、EMbase、中國知網(CNKI)及萬方數據庫中自建庫以來髮錶的有關比較減重手術與非手術減重患者的肥胖相關腫瘤髮病率的文獻.嚴格按照標準篩選後,評估文獻質量併提取數據資料,採用Review manager5.2軟件進行Meta分析,併進行敏感性分析,採用倒漏鬥圖檢驗髮錶偏倚.結果 5篇文獻的108 954例患者納入分析,其中減重手術組26 218例;對照組(非手術減重)82 736例.Meta分析結果顯示:減重手術能夠明顯降低患者術後肥胖相關腫瘤的髮生(RR=0.60,95％ CI:0.45～0.80,P=0.0005).亞組分析顯示,減重治療後,兩組男性患者肥胖腫瘤的髮病風險差異無統計學意義(P=0.74);而減重手術組女性患者術後髮生肥胖相關腫瘤的概率明顯低于對照組(RR=0.68, 95％ CI:0.61～0.77,P＜0.01).隨訪1～10年者,減重手術組的術後肥胖相關腫瘤髮生率明顯低于對照組(P＜0.05);而隨訪10年以上者,兩組的肥胖相關腫瘤髮生率差異無統計學意義(P=0.70).結論 減重手術可以降低肥胖相關性腫瘤的髮病風險,尤其女性患者;但隨著時間的延長,該作用不再顯現.
목적 탐토감중수술능부강저비반환자적비반상관종류발병솔.방법 통과계산궤검색PubMed、Medline、EBSCO、High Wire Press、OVID、EMbase、중국지망(CNKI)급만방수거고중자건고이래발표적유관비교감중수술여비수술감중환자적비반상관종류발병솔적문헌.엄격안조표준사선후,평고문헌질량병제취수거자료,채용Review manager5.2연건진행Meta분석,병진행민감성분석,채용도루두도검험발표편의.결과 5편문헌적108 954례환자납입분석,기중감중수술조26 218례;대조조(비수술감중)82 736례.Meta분석결과현시:감중수술능구명현강저환자술후비반상관종류적발생(RR=0.60,95％ CI:0.45～0.80,P=0.0005).아조분석현시,감중치료후,량조남성환자비반종류적발병풍험차이무통계학의의(P=0.74);이감중수술조녀성환자술후발생비반상관종류적개솔명현저우대조조(RR=0.68, 95％ CI:0.61～0.77,P＜0.01).수방1～10년자,감중수술조적술후비반상관종류발생솔명현저우대조조(P＜0.05);이수방10년이상자,량조적비반상관종류발생솔차이무통계학의의(P=0.70).결론 감중수술가이강저비반상관성종류적발병풍험,우기녀성환자;단수착시간적연장,해작용불재현현.
Objective To explore whether bariatric surgery can decrease the incidence of obesity-related tumors in obesity patients.Methods Relevant studies comparing the incidence of obesity-related tumors in obesity patients between bariatric surgery and non-bariatric surgery were identified by search of PubMed, Medline, EBSCO, High Wire Press, OVID, EMbase, China hownet (CNKI) and Wanfang databases since the self-built database.In strict accordance with the standard after the screening, literature quality and extracted data were evaluated.Review manager 5.2 software was used to perform meta-analysis and sensitivity analysis.Inverted funnel chart was used to investigate the publication bias.Results Five articles including 108 954 patients were enrolled in the analysis.Among them, 26 218 cases were bariatric surgery group, and 82 736 cases of non-surgical weight loss were the control group.Meta analysis showed that bariatric surgery could obviously decrease the incidence of postoperative obesity-related tumor (RR=0.60, 95％ CI:0.45-0.80, P=0.0005).Subgroup analysis showed that cancer risk difference of obesity-related tumor in male patients was not significant between two group, while the postoperative incidence of obesity-related tumor of female patients in bariatric surgery group was significantly lower compared to those female patients in control group (RR=0.68, 95％ CI:0.61-0.77, P＜0.01).During follow-up of 1 to 10 years, the incidence of obesity-related tumor in bariatric surgery group was significantly lower than that in control group (P＜0.05).When follow-up was more than 10 years, the incidence of obesity-related tumors was similar between two groups (P=0.70).Conclusion Bariatric surgery can decrease the overall risk of obesity-related cancer, especially for female patients, but with the prolongation of time, such effect of bariatric surgery is not obvious.
