单孔与传统腹腔镜脾切除术临床效果的系统评价  

Systematic review of the clinical effectiveness of single-incision and conventional laparoscopic splenectomy

作　　者：刘新农[1] 张锦航[1] 盛蕾[1] 王磊[1] 

机构地区：[1]山东大学齐鲁医院,山东济南250012

出　　处：《腹腔镜外科杂志》2013年第6期401-406,共6页Journal of Laparoscopic Surgery

基　　金：山东省科技攻关计划(编号:26010104011234)

摘　　要：目的:系统评价单孔法腹腔镜脾切除术(single incision laparoscopic splenectomy,SILS)与传统腹腔镜脾切除术(conventional laparoscopic splenectomy,CLS)的安全性及临床效果。方法:计算机检索Cochrane图书馆、MEDLINE、EMBASE、CBM、CNKI、VIP等数据库,检索时限自1990年1月至2013年4月,纳入SILS与CLS随机对照或病例对照研究。由2名评价者独立评价并交叉核对纳入研究质量后,采用RevMan 5.1.2软件包进行Meta分析。结果:经筛选,最终纳入5个病例对照研究,共135例受试者。NOS评分评价结果显示,5个研究均为中等及以上质量的研究。Meta分析结果表明,SILS组与CLS组患者在术中出血量、手术时间、住院时间、并发症发生率及中转开腹方面差异无统计学意义,尤其SILS组手术时间较LS组并未明显延长。结论:SILS与CLS临床效果及安全性相似,为下一步开展大样本、多中心的随机对照试验提供了初步证据;为获得对SILS更全面、更准确的评价,建议以后的研究重点对美容效果及镇痛效果进行评估。Objective：To evaluate the safety and clinical effect of single incision laparoscopic splenectomy（SILS） and conventional laparoscopic splenectomy（CLS）.Methods：The Cochrane Library,MEDLINE,EMBASE,CBM,CNKI,VIP and other database were searched from Jan.1990 to Apr.2013,including the randomized control or case-control study about comparison of SILS and CLS.The quality of included studies was evaluated independently and cross-checked by two reviewers,and the Meta-analysis was performed using RevMan 5.1.2 software package.Results：Five case-control study（135 subjects） were ultimately included in this Meta-analysis.NOS score evaluation results showed that the five studies were graded as moderate or high by NOS score.Meta-analysis results showed there was no significant difference in term of blood loss,operative time,hospital stay,incidence of complications and conversion to laparotomy between SILS and CLS patients.Notly,the operative time was not significantly prolonged in the SILS patients.Conclusions：The clinical efficacy and safety are similar between SILS and CLS,which may provide preliminary evidence for carrying out a large sample,multi-center randomized controlled trials;to get more comprehensive and accurate evaluation for SILS,it is recommended that subsequent research focus on its cosmetic and analgesic effect.

关 键 词：脾切除术 单孔 腹腔镜检查 META分析 病例对照研究 

分 类 号：R657.6[医药卫生—外科学]