腹腔镜结直肠癌手术的安全性与近期疗效评估Meta分析  

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

作　　者：胡登华[1] 傅仲学[1] 李尚坤[1] 

机构地区：[1]重庆医科大学附属第一医院胃肠外科,400016

出　　处：《重庆医学》2009年第14期1774-1776,共3页Chongqing medicine

摘　　要：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140mL[95%CI(-145.01^-135.69),P<0.01],但手术时间延长14min[95%CI(11.31~17.47),P<0.01]。标本长度较开腹手术短0.22cm[95%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4.5d[95%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。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 LR group were similar to those of the OR group. In comparison with the OR group,the blood loss was less by 140mL[95% CI（-145.01-135.69）,P〈0. 011 ,but the operation time was 14min more E95%CI（11.31-17.47）,P〈0.01]. There were no significant differences in the length of resected specimen and number of retrieved lymph nodes, the rate of stomal leak and infect happens less in LR group. The rates of DVT in LR group were the same as in OR group（P=0.97）. But LR groupPs hospital stay time was 4.5 days less than OR group [95%CI（-4.76-4.27） ,P〈0.01]. The mortality rate 3-5 years after operation was the same[-95%CI（0. 57-1. 09） ,P=0. 151. Conclusion By compared with OR,LR is as safe and effective as OR,in the treatment of colorectal cancer,And do less injure to patients.

关 键 词：结直肠肿瘤 腹腔镜 随机对照试验 META分析 

分 类 号：R735.37[医药卫生—肿瘤] R73-31[医药卫生—临床医学]