腹腔镜与传统开腹手术治疗国人远端胃癌的Meta分析  

Laparoscopc versus conventional open gastrectomy for distal gastric cancer in Chinese patients: a Meta-analysis

作　　者：马继春[1] 毛婧[1] 朱伟鹏[1] 孔菲菲[2] 袁野[1] 常航[1] 李金龙[1] 李兴旺[1] 姜雷[3] 

机构地区：[1]兰州大学第一临床医学院,甘肃兰州730000 [2]兰州大学药学院,甘肃兰州730000 [3]兰州大学第一医院肿瘤外科,甘肃兰州730000

出　　处：《中国普通外科杂志》2013年第10期1243-1251,共9页China Journal of General Surgery

基　　金：中央高校基本科研业务费专项资金资助项目(lzujbky-2013-160);兰州大学创新创业计划资助项目(20131073001508)

摘　　要：目的:系统评价腹腔镜与传统开腹手术治疗国人远端胃癌的有效性和安全性。方法:计算机检索国内外文献数据库(时限均从建库开始至2013年5月),收集腹腔镜与开腹手术治疗国人远端胃癌的随机对照试验,使用RevMan 5.2软件进行Meta分析。结果:最终纳入6个研究,555例患者,其中腹腔镜组278例,开腹组277例。Meta分析结果显示,与开腹组比较,腹腔镜组在术中出血量、术后排气时间、首次进食时间、术后住院时间、切口长度、术后镇痛剂的使用例数、并发症发生率均明显减少(均P<0.05);但手术时间延长、术中淋巴结清扫数目减少(均P<0.05)。结论:腹腔镜远端胃癌根治术围手术期并发症少,患者恢复快,安全可行,但手术时间长,术中淋巴结清扫数目少。Objective： To compare the safety and efficacy of laparoscopic and conventional open surgery for distal stomach cancer in Chinese patients. Methods： The literature of randomized controlled trials distal stomach cancer in Chinese patients was retrieved （RCTs） comparing laparoscopic and open surgery for by searching the national and international databasesfrom their inception date to May 2013. Meta-analysis was performed by using Revman 5.2 software. Results： Six RCTs involving 555 patients were finally selected, with 278 cases in laparoscopic surgery group and 277 cases in open surgery group. The results of Meta-analyses showed that the intraoperative blood loss, time to the first flatus and food intake, length of postoperative hospital sta）5 length of incision, number of patients using analgesics, and incidence of postoperative complications were significantly reduced in laparoscopic surgery group compared with open surgery group （all P〈0.05）; but the operative time was prolonged and number of the removed lymph nodes was decreased in laparoscopic surgery group versus open surgery group （all P〈0.05）. Conclusion： Laparoscopic distal radical gastrectomy is safe and reliable with less perioperative complications, faster postoperative recovery and shortened length of hospital stay, but with a prolonged operative time and decreased lymph node clearance.

关 键 词：胃肿瘤 腹腔镜 随机对照试验 META分析 

分 类 号：R735.2[医药卫生—肿瘤]