Meta-analysis of end colostomy versus loop colostomy for preventive colostomy / 国际外科学杂志

ABSTRACT

Objective To compare the complications of end colostomy and loop colostomy for preventive colostomy,then to evaluate which one is superior to the other.Methods Studies and relevant literatures comparing end colostomy with loop colostomy for defunctiong colostomy were searched by PubMed,Springer and Embase Library.The rates of complications were pooled and compared using a Meta analysis.The risk ratios were calculated with 95％ confidence intervals to evaluate the safety and efficacy of each teachnique.Results Six nonrandomized studies were included,with 1999 patients in total.The Meta-analysis of the non-randomied studies showed a lower risk of stoma retraction (RR0.21,95％ CI0.04 ～ 0.99,P =0.05) and stoma prolapse (RR0.23,95 ％ CI0.05 ～0.99,P =0.05) in the end colostomy group,but the higher risk of ischemia and necrosis (RR5.08,95％ CI1.94 ～ 13.22,P =0.05).No other statistically significant difference was observed for other complications.Conclusions Each type of defuncyioning stoma has its advantages and disadvantages.The study endorses end colostomy stoma over loop colostomy.However,there is not a strong evidence for the superiority of one colostomy over another for colostomy patients.So,large scale RCTs and high quality studies are needed.