腹腔镜结直肠癌手术的安全性与近期疗效评估Meta分析

目的 评价腹腔镜结直肠癌手术的安全性和近期疗效.方法 检索2000年至今已公开发表的比较腹腔镜结直肠癌手术与开腹手术近期临床效应差异的前瞻性随机对照试验(RCT)论文,提取近期临床效应指标进行Meta分析.结果 最终13项RCT纳入分析,腹腔镜手术组与开腹手术组患者基本特征均衡.腹腔镜手术组术中出血量较开腹手术组减少140mL95%CI(-145.01～-135.69),P＜0.01],但手术时间延长14min95%CI(11.31～17.47),P＜0.01].标本长度较开腹手术短0.22cm95%CI(-0.4～0.03),P=0.02].淋巴结检出数量两组相比,差异无统计学意义(P=0.99).腹腔镜组患者术后发生吻合口瘘及切口感染的相对危险度均低于开腹手术组;术后发生深静脉血栓的相对危险度与开腹组比较差异无统计学意义(P=0.97);住院时间比开腹组少4.5d95%CI(-4.76～-4.27),P＜0.01].两组术后3～5年死亡率差异无统计学意义95%CI(0.57～1.09),P=0.15].结论 腹腔镜辅助下行结直肠癌根治术是可行的、安全的,可以达到根治切除的目的 ,而且3～5年生存率与开腹组相似.

Meta-analysis of short-term efficacy and safety after laparoscopic resection for colorectal cancer

Objective To evaluate the short-term curative effects and safety of laparoscopic resection(LR) in treatment of colorectal cancer.Methods From all the databases,256 medical articles published in different areas were retrieved manually to search the literatures related to randomized controlled trials(RCTs) on the comparison between the effects and safety of LR and open resection(OR) in treatment of colorectal cancer.Results 13 articles were included into the meta-analysis.The baseline characteristics of the L...