胸腔镜与开胸肺叶切除术治疗非小细胞肺癌近期疗效的系统评价  

Comparison of Short-term Effect of Video-assisted Thoracoscopic Surgery Lobec- tomy and Thoracotomy Lobectomy in the Treatment of Non-small cell Lung Cancer: A Systematic Review

作　　者：张雪飞[1] 史小男[1] 韩彪[2] 

机构地区：[1]兰州大学第一临床医学院,兰州730000 [2]兰州大学第一附属医院胸外科,兰州730000

出　　处：《中国肺癌杂志》2012年第7期422-428,共7页Chinese Journal of Lung Cancer

摘　　要：背景与目的肺癌是临床上常见的恶性肿瘤,本研究系统评价胸腔镜与开胸肺叶切除术治疗非小细胞肺癌的近期疗效。方法通过计算机检索Cochrane Library、Embase、Pubmed、CBM、CNKI、VIP等数据库,收集有关胸腔镜与开胸肺叶切除术治疗非小细胞肺癌的随机对照研究,由两名评价者独立评价纳入研究的质量并提取资料,用RevMan5.0软件进行meta分析。结果共纳入5篇随机对照研究,共537例患者,meta分析结果显示:胸腔镜与开胸肺叶切除术治疗非小细胞肺癌相比,两组手术时间(SMD=0.27,95%CI:0.10-0.44)、胸腔引流量(SMD=-0.23,95%CI:-0.45--0.01)、术后住院时间(SMD=-0.25,95%CI:-0.46--0.05)、并发症发生率(SMD=0.51,95%CI:0.32-0.80)等方面的差异有统计学意义;而两组术中淋巴结清扫个数(SMD=-0.01,95%CI:-0.22-0.19)的差异无统计学意义。结论胸腔镜肺叶切除术与开胸肺叶切除术相比,治疗非小细胞肺癌的淋巴结清扫个数相当,但在术中出血量、手术时间、胸腔引流液量、术后住院时间等方面有差异。Background and objective Lung cancer is a common malignant tumor. The aim of this studyis to assess the short-term effect of video-assisted thoracoscopic surgery lobectomy and thoracotomy lobectomy in the treatment of nonsmall cell lung cancer. Methods Cochrane Library, Embase, Pubmed, CBM, CNKI, VIP, and so on, were searched by computer. Randomized controlled trials comparing video-assisted thoracoscopic surgery lobectomy and thoracotomy lobectomy in the treatment of non-small cell lung cancer were collected. Two reviewers independently assessed the quality of included stud- ies and extracted data. We analyzed the data using Review Manager （Version 5.0）. Results Five randomized controlled trials totaling 537 patients were included. The results of meta analysis were as follows： statistically significant difference was found in operating time （SMD=0.27, 95%CI： 0.10-0.44）, chest tube drainage flow （SMD=-0.23, 95%CI： -0.45--0.01）, postopera- tive hospital stay （SMD=-0.25, 95%CI： -0.46--0.05）, and postoperative complications （SMD=0.51, 95%CI： 0.32-0.80）. No statistically significant difference was found in the harvested lymph nodes （SMD=-0.01, 95%CI： -0.22-0.19） between video- assisted thoracoscopic surgery lobectomy and thoracotomy lobectomy in the treatment of non-small cell lung cancer. Conclu- sion Compared with thoracotomy lobectomy in the treatment of non-small cell lung cancer, the amount of harvested lymph nodes was almost the same, but the amount of blood loss, operating time, chest tube drainage flow, and postoperative hospital stay were different.

关 键 词：肺肿瘤 胸腔镜肺叶切除术 开胸肺叶切除术 META分析 系统评价 

分 类 号：R734.2[医药卫生—肿瘤]