腹腔镜与开腹结直肠癌根治术对机体免疫系统影响的Meta分析

目的：应用 Meta分析评价结直肠癌腹腔镜切除术（LS）与开腹手术（OS）对机体免疫系统的影响。方法通过计算机检索 Embase、PubMed、Cohorane Library、Web of Science、Medline、万方、知网数据库，收集1991年1月-2013年12月发表的关于结直肠癌腹腔镜切除术与开腹手术术后机体免疫差异的随机对照研究，按照Meta分析的要求对初步检索到的所有研究结果进行质量评估，采用 Revman5．1软件对最终入选的研究结果进行分析。结果共纳入10项研究，其中腹腔镜组（LS组）276例，开腹组（OS组）286例。LS组术后 T0～1、T1～3时间段血浆中 IL-6明显低于 OS组（P ＜0．05），两组术后T3～7时间段差异无统计学意义。LS组术后 T1～3时间段血浆中CRP浓度明显低于 OS组（P ＜0．05），两组术后T0～1、T3～7时间段差异无统计学意义（P ＞0．05）。LS组术后3个时间段（T0～1、T1～3、T3～7）血浆中CD4＋均明显高于 OS组（P ＜0．05）。结论 LS组术后部分免疫指标比 OS组对人体更有利，但并没有足够的证据说明 LS组在术后免疫功能保护上有明显的优越性。

Laparoscopic versus open surgery for immune function in patients with colorectal cancer.A Meta analysis

Objective To evaluate the impact of the system Laparoscopic resection of colorectal cancer （LS） and open surgery （OS）on the immune system.Methods We searched EMBASE,PubMed,Cochrane Li-brary,Web of Science,Medline,WanFang data and CNKI from January 1991 to December 2013 for ran-domized trials comparing the immunological difference between LS and OS.Trial quality was assessed in accordance with the requirements of Meta-analysis and we used Revman5 .1 software to analyze the ulti-mately selected findings.Results A total of 562 cases （LS：276 and OS：286）from 10 trials were included in our study.Combined results showed that the IL-6 serum levels on postoperative day T0-1,T1-3,LS were significantly lower than those in OS group （P 〈0.05）,but there were no significant differences after T3-7.CRP serum levels on postoperative T1-3,LS were significantly lower than those in OS group （P〈0.05）,but on postoperative T0-1,T3-7 two groups did not differ significantly.CD8＋ serum levels on postoperative T1-3,T3-7 were not statistically significant.CD4＋ serum levels on Postoperative （T0-1,T1-3,T3-7）,LS group were significantly higher than those in the OS group （P 〈0.05）.Conclusion Al-though,compared with the OS group,some of the immune indexes of LS group are more beneficial to human body,there is no sufficient evidence to support superior preservation of global immune function with LS.