腹腔镜结直肠癌术后住院期间肠梗阻的荟萃分析

目的用荟萃分析（meta—analysis）的方法对已发表的比较结直肠癌腹腔镜手术和开腹手术后住院期间肠梗阻发生率的临床研究进行定量分析。方法收集1989年1月-2008年3月公开发表的比较结直肠癌患者腹腔镜手术和开腹手术后住院期间肠梗阻的发生情况的所有随机对照研究（randomized controlled trials，RCT），按照荟萃分析的要求对检索到的原始研究的质量进行评估，对符合条件的所有研究结果进行荟萃分析，计算腹腔镜手术组相对开腹手术组发生肠梗阻危险的优势比（oddsratio，OR），评价腹腔镜手术和开腹手术对患者术后住院期间肠梗阻发生率的影响。结果符合纳入标准的共12篇文章，总样本量3032例。其中腹腔镜手术组1522例，发生住院期间肠梗阻33例；开腹手术组1510例，发生住院期间肠梗阻71例；合并OR=0．46，95％可信区间0．30～0．69。结论相对于开腹结直肠癌手术，腹腔镜结直肠癌手术可以降低术后住院期间肠梗阻的发生率。

Meta analysis of Early Postoperative Small Bowel Obstruction after Laparoscopic Colorectal Resection

Objective To compare the efficacies of laparoscopic colorectal resection and conventional open surgery by collecting and investigating related studies with Meta-analysis.Methods Randomized controlled trials(RCT) on the outcomes of laparoscopic colorectal resection and conventional open surgery that published between January 1989 and March 2008 in English were collected and analyzed.The quality of the original investigations was evaluated,and the low-level reports were excluded.Then the odds ratio(OR) for the incidence of early postoperative small bowel obstruction between the two methods were calculated.ResultsTotally 12 studies including 3032 cases were analyzed.Among which,1522 patients received laparoscopy,33 of them developed early postoperative small bowel obstruction.1510 cases underwent open surgery,and 71 of these patients showed small bower obstruction before being discharged form hospital.The pooled OR was 0.46 with a 95% confidence interval of(0.30-0.69).Conclusion Compared with open surgery,laparoscopic colorectal resection is superior in the incidence of early postoperative small bowel obstruction.