保留脾脏胃癌根治术临床疗效的荟萃分析

目的 探讨胃癌根治术中保留脾脏与切除脾脏的术后并发症及5年生存率情况。方法 计算机检索Pubmed、EMABSE、CBM、维普、万方及中国知网数据库，检索时间截止至2014年2月，收集关于胃癌根治术中保留脾脏与切除脾脏的术后并发症及5年生存率的研究，由2名评价者按照纳入和排除标准独立选择文献、提取资料、评价质量，采用STATA 110软件进行分析，计算合并OR值及其95％CI并行敏感性分析和发表偏倚评估。结果 最终纳入16篇文献，包括1949例切除脾脏患者（切除组）和2864例保留脾脏患者（保留组）。纳入文献的结果在术后并发症发生率和5年生存率的比较模型中均无异质性。各模型Meta分析结果显示：胃癌根治术中切除组的并发症发生率高于保留组，差异有统计学意义（OR=1.699，95％ CI： 1.436～2.009）；且切除组的5年生存率低于保留组，差异亦有统计学意义（OR=0.402，95％ CI： 0.363～0.445）。结论 胃癌根治术中保留脾脏可降低术后并发症的发生，同时能提高患者生存率。

Meta analysis of curative effect analysis of spleen preservation in radical gastrectomy for gastric cancer

Objective To investigate the postoperative complications and 5-year survival rate of splenectomy and spleen preservation in radical gastrectomy for gastric cancer. Methods All eligible case-control studies published up to Febuary 2014 were searched out from PubMed,EMABSE,CBM,CNKI,VIP and WanFang databases. Two reviewers independently identified the literature according to inclusion and exclusion criteria. Meta-analysis was performed using STATA 11. 0 software to analyze. Results A total of 16 studies comprising 1949 patients with splenectomy（ resection group） and 2864 patients with splenic preservation（ preservation group） were finally included. The included studies showed good homogeneity in the models of postoperative complications and 5-year survival rate. Overall,the rate of postoperative complications was higher（ OR = 1. 699,95% CI： 1. 436-2. 009） and the 5-year survival rate was lower（ OR = 0. 402,95% CI： 0. 363-0. 445） in resection group versus preservation group（ P〈0. 05）. Conclusion The preservation of spleen in the radical gastrectomy for gastric cancer can reduce the incidence of postoperative complications and improve the survival of patients.