Meta-Analysis
Copyright ©The Author(s) 2024. Published by Baishideng Publishing Group Inc. All rights reserved.
World J Gastrointest Surg. May 27, 2024; 16(5): 1420-1429
Published online May 27, 2024. doi: 10.4240/wjgs.v16.i5.1420
Prognostic factors associated with gastrointestinal dysfunction after gastrointestinal tumor surgery: A meta-analysis
Jia Song, Cong Zhou, Tian Zhang
Jia Song, Department of Operating Room, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, Jiangsu Province, China
Cong Zhou, Department of Gastrointestinal Surgery, Tongji Hospital of Huazhong University of Science and Technology, Wuhan 430073, Hubei Province, China
Tian Zhang, Department of Disinfection Supply Center, The Fourth Affiliated Hospital of Nanjing Medical University, Nanjing 210031, Jiangsu Province, China
Author contributions: Song J wrote the manuscript; Zhou C collected the data; Zhang T guided the study. All authors reviewed, edited, and approved the final manuscript and revised it critically for important intellectual content, gave final approval of the version to be published, and agreed to be accountable for all aspects of the work.
Conflict-of-interest statement: The authors deny any conflict of interest.
PRISMA 2009 Checklist statement: The authors have read the PRISMA 2009 Checklist, and the manuscript was prepared and revised according to the PRISMA 2009 Checklist.
Open-Access: This article is an open-access article that was selected by an in-house editor and fully peer-reviewed by external reviewers. It is distributed in accordance with the Creative Commons Attribution NonCommercial (CC BY-NC 4.0) license, which permits others to distribute, remix, adapt, build upon this work non-commercially, and license their derivative works on different terms, provided the original work is properly cited and the use is non-commercial. See: https://creativecommons.org/Licenses/by-nc/4.0/
Corresponding author: Tian Zhang, Nurse, Department of Disinfection Supply Center, The Fourth Affiliated Hospital of Nanjing Medical University, No. 298 Nanpu Road, Jiangbei New District, Nanjing 210031, Jiangsu Province, China. axun418@163.com
Received: January 30, 2024
Revised: April 5, 2024
Accepted: April 15, 2024
Published online: May 27, 2024
Processing time: 113 Days and 21.1 Hours
Abstract
BACKGROUND

Explore the risk factors of gastrointestinal dysfunction after gastrointestinal tumor surgery and to provide evidence for the prevention and intervention of gastrointestinal dysfunction in patients with gastrointestinal tumor surgery.

AIM

To investigate the potential risk factors for gastrointestinal dysfunction following gastrointestinal tumor surgery and to present information supporting the prevention and management of gastrointestinal dysfunction in surgery patients.

METHODS

Systematically searched the relevant literature from PubMed, Web of Science, Cochrane Library, Embase, CNKI, China Biomedical Database, Wanfang Database, and Weipu Chinese Journal Database self-established until October 1, 2022. Review Manager 5.3 software was used for meta-analysis after two researchers independently screened literature, extracted data, and evaluated the risk of bias in the included studies.

RESULTS

A total of 23 pieces of literature were included, the quality of which was medium or above, and the total sample size was 43878. The results of meta-analysis showed that the patients were male (OR = 1.58, 95%CI: 1.25-2.01, P = 0.002) and ≥ 60 years old (OR = 2.60, 95%CI: 1.76-2.87, P < 0.001), physical index ≥ 25.3 kg/m2 (OR = 1.6, 95%CI: 1.00-1. 12, P = 0.040), smoking history (OR = 1.89, 95%CI: 1.31-2.73, P < 0.001), chronic obstructive pulmonary disease (OR = 1.49, 95%CI: 1.22-1.83, P < 0.001), enterostomy (OR = 1.47, 95%CI: 1.26-1.70, P < 0.001), history of abdominal surgery (OR = 2.90, 95%CI: 1.67-5.03, P < 0.001), surgical site (OR = 1.2, 95%CI: 1.40-2.62, P < 0.001), operation method (OR = 1.68, 95%CI: 1.08-2.62, P = 0.020), operation duration (OR = 2.65, 95%CI: 1.92-3.67, P < 0.001), abdominal adhesion grade (OR = 2.52, 95%CI: 1.90-3.56, P < 0.001), postoperative opioid history (OR = 5.35, 95%CI: 3.29-8.71, P < 0.001), tumor TNM staging (OR = 2.58, 95%CI: 1.84-3.62, P < 0.001), postoperative blood transfusion (OR = 2.92, 95%CI: 0.88-9.73, P = 0.010) is a risk factor for postoperative gastrointestinal dysfunction in patients with gastrointestinal tumors.

CONCLUSION

There are many factors affecting gastrointestinal dysfunction in gastrointestinal patients after surgery. Clinical staff should identify relevant risk factors early and implement targeted intervention measures on the basis of personalized assessment to improve the clinical prognosis of patients.

Keywords: Gastrointestinal tumor surgery; Postoperative gastrointestinal dysfunction; Intestinal paralysis; Risk factors; Meta-analysis

Core Tip: Our study conducted meta-analysis to investigate prognostic factors associated with gastrointestinal dysfunction after surgery for gastrointestinal tumors. Through systematic integration of existing literature, we will further study the survival rate, quality of life, complication rate, and other indicators of patients after surgery and analyze the relationship between them and factors such as patient age, tumor type, and surgical method. It is helpful to provide clinicians with more accurate postoperative management strategies to promote patients' recovery and quality of life. Our study will also provide an important reference basis to enhance the understanding and attention given to the postoperative recovery process.