进展期胃癌术中腹腔化疗临床疗效及安全性Meta分析

目的:探讨术中腹腔化疗在进展期胃癌手术治疗中的安全性及对生存率的影响。方法:检索中国期刊全文数据库(CNKI)、万方数据库、PubMed等数据库，发表时间为建库以来至2018年9月1日，文献的语种为中文和英文，应用Meta分析的方法，对纳入研究的10篇文献进行研究，以单纯胃癌手术为对照组，以胃癌手术联合术中腹腔化疗为治疗组，比较两组患者在术后并发症及术后生存率，以判断进展期胃癌术中腹腔化疗的安全性及临床疗效。结果:纳入10篇文献，共有921例进展期胃癌患者，其中506名患者接受了胃癌根治术，415名患者在接受胃癌根治术的基础上行术中的腹腔化疗。与对照组相比，腹腔化疗在术后出血、术后感染、术后吻合口瘘及术后肠梗阻方面，差异无统计学意义（P=0.95、P=0.26、P=0.41，P=0.11）；在术后1年、2年、3年、5年生存率区别较明显，差异有统计学意义（P=0.003、P＜0.000 01、P＜0.000 01、P＜0.000 01）。结论:进展期胃癌术中应用腹腔化疗可提高患者术后生存率，并不增加术后并发症的发生率，临床有效且安全。

Meta analysis on the clinical efficacy and security of intraperitoneal chemotherapy in patients with advanced gastric cancer

Objective:To investigate the security of intraoperative intraperitoneal chemotherapy in the surgical treatment of advanced gastric cancer and its effect on survival.Methods:Chinese journal full text database(CNKI),WanFang database,PubMed and other databases were searched.The publication date was from the date of database construction to September 1,2018,the literature is available in Chinese and English.Meta analysis was applied to study the 10 literatures included in the study.Gastric cancer surgery alone was used as the control group,and gastric cancer surgery combined with intraoperative abdominal chemotherapy was used as the control group.The postoperative complications and survival rates of the two groups were compared to determine the safety and clinical efficacy of intraperitoneal chemotherapy in patients with advanced gastric cancer.Results:A total of 921 patients with advanced gastric cancer were included in 10 literatures,including 506 patients who underwent radical gastrectomy and 415 patients who underwent peritoneal chemotherapy on the basis of radical gastrectomy.Compared with the control group,there was no statistically significant difference in postoperative bleeding,postoperative infection,postoperative anastomotic fistula and postoperative intestinal obstruction after abdominal chemotherapy(P=0.95,P=0.26,P=0.41， P=0.11).There were significant differences in 1-year,2-year,3-year and 5-year survival rates after surgery,with statistically significant differences (P=0.003,P＜0.000 01,P＜0.000 01,P＜0.000 01).Conlusion:Intraperitoneal chemotherapy can improve the postoperative survival rate of patients with advanced gastric cancer without increasing the incidence of postoperative complications,which is clinically effective and safe.