标准及扩大根治术治疗胰头癌疗效的meta分析

目的运用meta分析评估扩大根治术及标准根治术治疗胰头癌的远期疗效。方法检索Pubmed、WOS、Embase、万方、中国生物医学文摘及中国知网数据库1990～2012年期间的相关文献，运用Jadad评分评估所涉文献的研究质量。治疗组为胰头癌扩大根治术后患者，对照组为标准根治术后患者，运用meta分析评估2组患者的死亡率、并发症发生率，以及术后1、3及5年生存率的差异。结果11篇文献人选，纳入病例744例，其中标准根治组357例，扩大根治组387例。结果显示：①2组患者术后并发症发生率的差异无统计学意义（OR=1．360，95％CI=0．990～1．870，P=0．050）。②2组患者术后死亡率的差异无统计学意义（OR=0．870，95％CI=0．430-1．760，P=0．700）。⑨2组患者术后1、3及5年生存率的差异均无统计学意义（OR=0．880，95％CI=0．450～1．720，P=0．710；OR=0．940，95％CI=0．590～1．480，P=0．710；OR=1．000，95％CI=0．600～1．670，P=1．000）。结论同标准根治术相比，扩大根治术不能改善患者术后1、3及5年生存率，不能降低死亡率及术后并发症发生率。

Meta-Analysis of The Efficacy of Standard and Extended Radical Resection for Carcinoma of The Head of Pancreas

Objective To evaluate the long-term efficacy of extended and standard surgery for carcinoma of head of pancreas by using meta-analysis. Methods Related articls （1990-2012） were searched in Pubmed, WOS, Embase, WanFang, SinoMed, and CNKI. Study on quality of these literatures were evaluated by using the Jadad score. The patients with pancreatic head carcinoma underwent extended radical resection and standard radical resection were classified to treatment group and control group, respectively. The mortality, morbidity, and survival rates of 1-, 3-, and 5-year after operation in the two groups were evaluated by using meta-analysis. Results A total of 11 studies fitted the selection crit- eria, including 744 patients. Among them 357 cases were in standard radical resection group and 387 cases in the extended radical resection group. The results of meta-analysis showed that： ① The morbidity after operation did not significantly differed between the extended radical resection group and standard radical resection group （OR=1.360, 95% CI：0. 990- 1. 870, P=0. 050）. ②The mortality of the two groups did not significantly differed （OR=0. 870, 95% CI：0. 430-1. 760, P=0. 700）. ③There were no significant differences in survival rates of 1-, 3-, and 5-year between the two groups （OR= 0. 880, 95% CI：0. 450-1. 720, P=0. 710; OR=0. 940, 95% CI=0. 590-1. 480, P=0. 710; OR=1.000, 95% CI=0. 600- 1.67, P=1. 000）. Conclusion Compared with standard radical resection, extended radical resection can not improve the survival rates of 1-, 3-, and 5-year after operation, and can＇t reduce the mortality and morbidity after operation.