腹腔镜保留盆腔自主神经直肠癌根治术对排尿及性功能影响的Meta分析  

Urinary and sexual functions after laparoscopic pelvic autonomic nerve-preserving radical resection: a meta-analysis

作　　者：高飞[1] 庞志刚[1] 陈文超[1] 韩斌[1] 

机构地区：[1]郑州大学第二附属医院普外科,河南郑州450014

出　　处：《中国临床研究》2015年第7期868-872,共5页Chinese Journal of Clinical Research

摘　　要：目的 系统评价腹腔镜保留盆腔自主神经直肠癌根治术（L-PANP）与传统开腹手术（O-PANP）治疗对直肠癌男性患者的排尿及性功能的影响。方法 计算机检索Pub Med、Embase、The Cochrane library、Web of Science、CBM、CNKI、VIP和Wan Fang等数据库,搜集从建库至2015年2月L-PANP与O-PANP的随机与非随机临床对照试验,按Cochrane系统评价的方法筛选文献,按纳入标准提取数据并进行质量评价;采用Rev Man 5.1软件进行Meta分析。结果 最终纳入9项研究,共934例患者。Meta分析结果显示,相比O-PANP组,L-PANP组能降低患者术后近期排尿功能障碍发生率（OR=0.32,95%CI：0.21~0.48,P〈0.01）,有效减少患者术后近期勃起功能障碍（OR=0.33,95%CI：0.23~0.49,P〈0.01）及射精功能障碍（OR=0.31,95%CI：0.25~0.53,P〈0.01）。两组患者在术后1年盆腔局部复发率方面无明显差异（OR=1.10,95%CI：0.27~4.57,P〉0.05）。结论 L-PANP能有效保护患者术后的排尿及性功能,改善患者生活质量。但由于纳入文献的类型及评价质量不高等因素的限制,尚需谨慎对待此结论。Objective To assess the impact of laparoscopic pelvic autonomic nerve-preserving radical resection （L- PANP） versus conventional laparotomy surgery （O-PANP） on the urinary and sexual functions for the male rectal cancer patients. Methods The PubMed, Embase, Cochrane library, Web of science, CBM, CNKI, VIP and WanFang databases were electronically searched. The randomized controlled trials and retrospective nonrandomized trial from building databases to February 2015 were collected, and the literatures were screened according to the Cochrane method. The data were extracted according to the inclusion criteria, and the methodological quality was assessed. The meta-analysis was performed by RevMan 5.1 software. Results Nine researches involving 934 patients were included. The results of recta-analysis showed that the incidence of recent urinary function disorder in L-PANP group significantly decreased compared with O-PANP group（ OR = 0. 32,95% CI：O. 21 - 0.48, P 〈 0. 01 ） ;the incidences of recent erectile function disorder （ OR = 0. 33,95% CI：0. 23 -0.49, P 〈 0.01 ） and recent ejaculation function disorder in L-PANP group （ OR = 0.37,95% CI：0. 25 - 0.53, P 〈 0.01 ） significantly decreased compared with O-PANP group. There was no significant difference in local recurrence rate at one year after operation between the two groups （ OR = 1.10,95% CI： 0.27 - 4.57, P 〉 0.05 ）. Conclusion L-PANP can effectively preserve patients＇ postoperative urinary function and sexual function and improve patients＇ life quality, however,this conclusion still need to be interpreted with caution because of the limits of including literature types and evaluation quality.

关 键 词：盆腔自主神经 保留 腹腔镜 直肠癌根治术 全系膜切除 排尿功能 性功能 META分析 

分 类 号：R735.37[医药卫生—肿瘤]