| 腹腔镜与传统开腹手术治疗结肠癌的疗效和术后并发症的Meta分析 |
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| 引用本文： | 乔正博,洪书剑,彭辉,庞姗姗,黄埔,李强,黄鹤. 腹腔镜与传统开腹手术治疗结肠癌的疗效和术后并发症的Meta分析[J]. 中华全科医学, 2016, 14(7): 1090. DOI: 10.16766/j.cnki.issn.1674-4152.2016.07.009 |
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| 作者姓名： | 乔正博 洪书剑 彭辉 庞姗姗 黄埔 李强 黄鹤 |
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| 作者单位： | 1. 皖南医学院附属弋矶山医院胃肠外科, 安徽 芜湖 241001; |
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| 基金项目： | 安徽高校省级自然科学研究计划项目(KJ2008-B326)安徽省卫生厅医学科研课题计划项目(2010C075) |
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| 摘 要： | 目的 应用Meta分析的方法对腹腔镜与传统开腹手术治疗结肠癌的疗效和术后并发症进行对比。 方法 自CNKI、维普等数据库检索2005年1月—2015年1月收录的对比腹腔镜与传统开腹手术治疗结肠癌的疗效和术后并发症的随机对照研究。制定文献纳入的标准，严格按照标准筛选文献。提取数据资料，用RevMan 4.7进行Meta分析。 结果 共纳入文献25篇，全体样本量合计2 766例，其中腹腔镜手术治疗组1 392例，开腹手术治疗组1 374例。基本数据中除体重指数外，2组患者的年龄、性别差别均无统计学意义。Meta分析结果提示:腹腔镜手术治疗组手术时间[WMD=14.81，95%CI(-0.44，30.05)，P=0.06]、淋巴结清除数量[WMD=-0.40，95%CI(-0.79，-0.00)，P=0.05]与传统开腹手术治疗组相比差异无统计学意义，但腹腔镜手术治疗组术中出血量少[WMD=-86.10，95%CI(-102.14，-70.05)，P＜0.000 01]，术后排气时间短[WMD=-1.32，95%CI(-1.66，-0.99)，P＜0.000 01]，住院天数缩减[WMD=-4.25，95%CI(-5.62，-2.87)，P＜0.000 01]。腹腔镜组肠梗阻的发生率低于开腹组(16% vs.58%，P=0.000 3)，术后发生肠瘘的几率低(5% vs.67%，P=0.01)。2组患者的3年生存率、5年生存率、5年复发率相比较，差异均无统计学意义(P＞0.05)。 结论 应用腹腔镜技术治疗结肠癌，短期疗效具有明显优势，术后并发症发生率低，而远期疗效与开腹手术相似，在临床上值得大力推广。
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| 关 键 词： | 结肠癌 Meta分析 腹腔镜手术 开腹手术 疗效 术后并发症 |
| 收稿时间： | 2015-12-29 |
A Meta-analysis of the outcomes and postoperative complications of laparoscopic and open surgery for colonic cancer |
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| Affiliation: | Department of General Surgery, Yijishan Hospital of Wannan Medical College, Wuhu, Anhui 241001, China |
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| Abstract: | Objective To evaluate the outcomes and postoperative complications of laparoscopic surgery and open surgery for colonic cancer. Methods The reported randomized controlled trials on the outcomes and postoperative complications of laparoscopic versus open surgery for colonic cancer between Jan.2005 and Jan.2015 were collected by searches of CNKI and VIP.The criteria of literature enrollment and exclusion was made,strictly according to which the literatures were screened.Data were extracted from these literatures,and data analysis was performed by RevMan 4.7. Results A total of 2 766 patients from 25 literatures was selected,including 1 392 patients in the laparoscopic surgery group and 1 374 patients in the open surgery group.Except body mass index,the age and gender were similar between the two groups.The results of this Meta-analysis indicate that the operation time and number of lymph node dissection in both group had no statistical differences(P>0.05),while the intraoperative blood less,intestinal function recovery time,average time of hospital stay were evidently lower and shorter than the patients in the open surgery group(P<0.05).Moreover,the incidences of intestinal obstruction and intestinal fistula were lower than the open group(P<0.05).There was no statistically significant difference in the Long-term outcomes between the two groups(P>0.05),including recurrence rate in 5 years,survival rate in 3 years and 5 years. Conclusion The long-term outcomes of laparoscopic surgery group are similar to that of open surgery group for colon cancer,however,the laparoscopic surgery group has obvious advantages in short-term outcomes and postoperative complications.Therefore,laparoscopic surgery for colon cancer is an acceptable alternative. |
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