胃癌根治性手术联合脾切除必要性的Meta分析  

Necessity of splenectomy in radical resection of gastric cancer： a meta-analysis

作　　者：丁杰[1] 廖国庆[2] 张忠民[1] 潘扬[1] 倪青[1] 郝朗松[1] 王润华[1] 李东苗[1] 

机构地区：[1]贵州省人民医院胃肠外科, 贵阳550002 [2]中南大学湘雅医院胃肠外科

出　　处：《中华胃肠外科杂志》2011年第2期120-124,共5页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的评价胃癌根治手术联合脾切除的必要性。方法以Medline、the Cochrane Library数据库作为已发表国外文献的主要来源．以万方数据知识服务平台及中国知网数据出版平台作为已发表国内文献的主要来源：检索时间：2010年10月12日。收集1990-2010年公开发表的有关胃癌根治性手术切除与保留脾脏两种术式疗效的中文和英文文献．对切脾组和保脾组术后并发症发生率及5年生存率进行Meta分析。结果筛选出符合纳入标准的研究12项（2628例）。切脾组900例，保脾组1728例。两组术后并发症发生率的差异有统计学意义（DR=1．91，95％CI：1．28～2．87，P〈0．05）；5年生存率的差异无统计学意义（HR=0．90，95％CI：0．73。1．11．P〉0．05）。结论联合脾切除的胃癌根治性手术不能改善胃癌患者的预后．且使胃癌患者的术后并发症增多。Objective To evaluate the necessity of splenectomy in radical resection of gastric cancer. Methods Twelve studies comparing outcomes after radical resection of gastric cancer with or without splenectomy were identified. Both fixed effect model and random effect model were used. Results There were 2628 patients in total. There were significant differences in complications between splenectomy group and spleen-preserving group （OR=1.91, 95% CI： 1.28-2.87, P〈0.05）, while no significant difference in 5-year survival rate was noticed （HR=0.90, 95% C1：0.73-1.11, P〉0.05）. Conclusion Radical resection of gastric cancer combined with splenectomy is not associated with improved survival but increased postoperative complications.

关 键 词：胃肿瘤 脾切除术 并发症 生存率 META分析 

分 类 号：R735.2[医药卫生—肿瘤]