| Ivor Lewis和Sweet术式治疗食管癌疗效及安全性的Meta分析 |
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| 引用本文： | 贺晓阳,金大成,王 兵,杨 宁,张斯渊,苟云久.Ivor Lewis和Sweet术式治疗食管癌疗效及安全性的Meta分析[J].现代肿瘤医学,2021,0(18):3187-3192. |
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| 作者姓名： | 贺晓阳 金大成 王 兵 杨 宁 张斯渊 苟云久 |
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| 作者单位： | 1.甘肃中医药大学第一临床医学院，甘肃 兰州 730000；2.甘肃省人民医院，甘肃 兰州 730000 |
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| 基金项目： | 甘肃省卫生行业计划（编号:GSWSKY2017-56） |
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| 摘 要： | 目的:探讨食管癌切除术Ivor Lewis和Sweet两种术式的临床治疗效果及心肺保护作用。方法:检索PubMed、Web of Science、The Cochrane Library、EMBASE、CNKI、Wanfang Data、VIP和CBM数据库，最终纳入24篇文献，其中包括21篇病例对照研究、3篇随机对照研究(RCT)，总共包含5 082例患者，其中行Ivor Lewis术式患者2 241例，行Sweet术式患者2 841例。采用RevMan5.3进行Meta分析。结果:术后心血管并发症发生率Meta分析结果得出［OR=0.50，95%CI(0.25,1.01)，P=0.05］，差异有统计学意义。术后肺部并发症发生率Meta分析结果得出［OR=0.69,95%CI(0.48,0.99)，P=0.04］，差异有统计学意义。术后吻合口瘘发生率Meta分析结果得出［OR=0.83,95%CI(0.51,1.35)，P=0.45］，差异无统计学意义。术后喉返神经损伤发生率Meta分析结果得出［OR=1.57，95%CI(0.75,3.27)，P=0.23］，差异无统计学意义。3年生存率Meta分析结果得出［OR=1.91，95%CI(1.29,2.81)，P=0.001］，Ivor Lewis组患者术后3年生存率高于Sweet组，差异有统计学意义。手术时间Meta分析结果得出［MD=30.61,95%CI(14.48,46.74),P=0.000 2］，差异有统计学意义。淋巴结清扫数目Meta分析结果得出［MD=5.81,95%CI(4.63,6.99),P＜0.001］，差异有统计学意义。术中出血量Meta分析结果得出［MD=4.54,95%CI(-4.54，13.63)，P=0.33］，差异无统计学意义。术后住院天数Meta分析结果得出［MD=-0.59,95%CI(-1.80,0.61),P=0.33］，差异无统计学意义。结论:与Sweet手术相比，Ivor Lewis手术在淋巴结清扫、心肺并发症发生率以及生存率方面有较大优势。而在手术时间方面，传统Sweet手术更具优势。
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| 关 键 词： | Ivor Lewis手术 Sweet手术 食管癌 Meta分析 |
Efficacy and safety of Ivor Lewis and Sweet in the treatment of esophageal cancer:A Meta-analysis |
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| HE Xiaoyang,JIN Dacheng,WANG Bing,YANG Ning,ZHANG Siyuan,GOU Yunjiu.Efficacy and safety of Ivor Lewis and Sweet in the treatment of esophageal cancer:A Meta-analysis[J].Journal of Modern Oncology,2021,0(18):3187-3192. |
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| Authors: | HE Xiaoyang JIN Dacheng WANG Bing YANG Ning ZHANG Siyuan GOU Yunjiu |
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| Affiliation: | 1.The First Clinical Medical College of Gansu University of Chinese Medicine,Gansu Lanzhou 730000,China;2.Gansu Provincial Hospital,Gansu Lanzhou 730000,China. |
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| Abstract: | Objective:To explore the clinical therapeutic effect and cardiopulmonary protective effect of the resection of esophageal cancer with Ivor Lewis and Sweet.Methods:the PubMed,Web of Science,The Cochrane Library,EMBASE,CNKI,Wanfang Data,VIP and CBM databases were searched.A total of 24 literatures were included,and 5 082 patients were collected,including 2 241 patients with Ivor Lewis operation and 2 841 patients with Sweet operation.RevMan 5.3 was used for Meta-analysis.Results:According to the results of Meta-analysis of the incidence of postoperative cardiovascular complications ［OR=0.50,95%CI(0.25,1.01),P=0.05］,the difference was statistically significant.According to the results of Meta-analysis of the incidence of postoperative pulmonary complications ［OR=0.69,95%CI(0.48,0.99),P=0.04］,the difference was statistically significant.There was no significant difference in the incidence of anastomotic leakage ［OR=0.83,95%CI(0.51,1.35),P=0.45］.There was no significant difference in the incidence of recurrent laryngeal nerve injury ［OR=1.57,95%CI(0.75,3.27),P=0.23］.Meta-analysis of 3-year survival rate showed that ［OR=1.91,95%CI(1.29,2.81),P=0.001］ the 3-year survival rate of Ivor Lewis group was higher than that of Sweet group.Meta-analysis of operation time showed that ［MD=30.61,95%CI(14.48,46.74),P=0.000 2］ was statistically significant.The results of Meta-analysis of the number of lymph nodes dissected showed that ［MD=5.81,95%CI(4.63,6.99),P<0.001］ was statistically significant. There was no significant difference in intraoperative blood loss［MD=4.54,95%CI(-4.54,13.63),P=0.33］ between the two groups. There was no significant difference in postoperative hospitalization days［MD=-0.59,95%CI(-1.80,0.61),P=0.33］ between the two groups.Conclusion:Compared with Sweet operation,Ivor Lewis operation has more advantages in lymph node dissection,cardiopulmonary complications and survival rate. In terms of operation time,traditional Sweet operation has more advantages than Ivor Lewis. |
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| Keywords: | Ivor Lewis operation Sweet operation esophageal cancer Meta-analysis |
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