腹腔镜与开放腹股沟淋巴结清扫术疗效比较的Meta分析  

Meta-analysis of effect comparison between video endoscopic inguinal lymphadenectomy and open inguinal lymphadenectomy

作　　者：姚自翔[1] 王德林[1] 杨帆[1] 刘舜[1] 刘文聪[1] 张鑫[1] 

机构地区：[1]重庆医科大学附属第一医院泌尿外科,重庆400016

出　　处：《重庆医学》2014年第12期1422-1424,1427,共4页Chongqing medicine

基　　金：重庆市科学技术委员会科技攻关资助项目(cstc2012gg-yyjs10043)

摘　　要：目的：评价经腹腔镜与开放腹股沟淋巴结清扫术的疗效，为临床治疗方案的选择提供循证依据。方法检索PubMed、Cochrane图书馆、Elsevier、中国期刊全文数据库（CNKI）及万方等数据库有关腹腔镜下腹股沟淋巴结清扫术与开放腹股沟淋巴结清扫术疗效比较的临床对照研究相关文献，按纳入排除标准由2名研究者独立进行筛选并提取相关资料，采用Rev-Man5．2软件进行Meta分析。结果4篇文献纳入分析，腹股沟淋巴结清扫术共146例，其中腹腔镜手术61例，开放手术85例。结果表明，两种术式手术时间[加权均数差（WMD）＝32．33，95％CI-25．70～90．36，P＝0．27]、术中失血量（WMD＝9．10，95％CI-76．03～94．23，P＝0．83）、术后淋巴结清扫数量（WMD＝0．77，95％CI-1．66～3．20，P＝0．53）、阳性淋巴结数量（WMD＝0．08，95％CI-0．23～0．40，P＝0．61）、术后引流管留置时间（WMD＝-1．30，95％CI-6．40～3．80，P＝0．62）、住院时间（WMD＝-4．02，95％CI-10．19～2．15，P＝0．20）比较，差异无统计学意义（P＞0．05）；而两种术式的手术并发症比较，差异有统计学意义（OR＝0．08，95％CI0．03～0．26，P＜0．01）。结论腹腔镜腹股沟淋巴结清扫术疗效与开放手术相当，但手术并发症较开放手术少。Objective To evaluate the effects between video endoscopic inguinal lymphadenectomy （VEIL ） and open inguinal lymphadenectomy（OIL） to provide the evidence-based basis for the selection of the clinical therapy schemes .Methods The related clinical controlled trial literature on the effective comparison of VEIL and OIL were retrieved from the databases of PubMed ,Co-chrane library ,Elsevier ,CNKI and Wanfang database .The screening was independently performed by 2 reviewers according to the including and excluding criteria .The related data were extracted and performed the meta analysis by the RevMan 5 .2 software .Re-sults A total of 4 trials were included .There were 146 cases of inguinal lymphadenectomies ,in which 61 cases were VEIL and 85 cases were OIL .The meta-analysis results showed that there were no statistical differences between the two operation modes in terms of the operative time（WMD=32 .33 ,95% CI -25 .70-90 .36 ,P=0 .27） ,intraoperative blood loss（WMD=9 .10 ,95% CI -76 .03-94 .23 ,P=0 .83） ,number of removed lymph nodes（WMD=0 .77 ,95% CI -1 .66-3 .20 ,P=0 .53） ,number of positive re-moved lymph nodes（WMD=0 .08 ,95% CI -0 .23-0 .40 ,P=0 .61） ,postoperative drainage time（WMD= -1 .30 ,95% CI -6 .40 -3 .80 ,P=0 .62） ,postoperative hospital stay （WMD= -4 .02 ,95% CI -10 .19-2 .15 ,P=0 .20） ,but the difference between VEIL and OIL in term of surgical complications had statistical significance （OR=0 .08 ,95% CI 0 .03-0 .26 ,P〈0 .01） .Conclusion VEIL has equivalent efficacy to OIL ,but has less surgical complications .

关 键 词：腹腔镜 腹股沟 淋巴结切除术 阴茎肿瘤 外阴肿瘤 黑色素瘤 

分 类 号：R730.56[医药卫生—肿瘤]