体质指数对腹腔镜胃癌根治术短期结局影响的Meta分析  

Effect of body mass index on postoperative short-term outcomes of laparoscopy radical gastrectomy：a meta-analysis

作　　者：胡林[1] 李昌荣[1] 李伟峰[1] 李红浪[1] 

机构地区：[1]南昌大学第二附属医院胃肠外科,330006

出　　处：《中华胃肠外科杂志》2015年第8期826-831,共6页Chinese Journal of Gastrointestinal Surgery

摘　　要：目的：评价体质指数（BMI）在腹腔镜胃癌根治术中对患者术后短期结局的影响。方法计算机检索PubMed、EMBASE、万方数据库、CNKI和中国生物医学文献数据库（CBM），2014年10月前发表的有关高BMI与低BMI胃癌患者行腹腔镜胃癌根治术的文献，采用RevMan 5．2软件对所纳入的数据进行荟萃分析，应用Stata 12．0统计软件进行Begg及Egger检验以评估纳入文献的发表偏倚。结果12项回顾性队列研究共计4798例患者纳入分析，其中高BMI组1215例，低BMI组3583例。 Meta分析结果显示：与低BMI组相比，高BMI组患者手术时间延长（SMD＝0．64，95％CI：0．35-0．93，P＝0．000），失血量较多（SMD＝0．63，95％CI：0．24-1．03，P＝0．002），清扫淋巴结数量较少（SMD＝－0．44，95％CI：－0．72-－0．17，P＝0．002）、术后总并发症发生率较高（OR＝1．44，95％CI：1．19-1．74， P＝0．000）；两组间住院时间、术后恢复排气时间及分项比较并发症发生情况的差异无统计学意义（均P＞0．05）。结论高BMI会导致腹腔镜胃癌根治术手术时间延长，术中出血量增加，术后并发症发生风险增大。Objective To evaluate the effect of body mass index （BMI） on postoperative short-term outcomes of laparoscopy radical gastrectomy by meta-analysis. Methods A literature search was performed in PubMed, EMBASE, Cochrane Library databases, CNKI, and CBM, Wanfang database to screen clinical trials published before October 2014 that compared short-term outcomes between high BMI and low BMI patients undergoing laparoscopy radical gastrectomy. RevMan 5.2 was used to perform the meta-analysis. Begg′s and Egger′s tests were carried out with Stata 12.0 software to evaluate the publication bias of enrolled literatures. Results Twelve studies involved a total of 4798 gastric cancer patients after laparoscopy radical gastrectomy. There were 1215 patients in high BMI group （BMI≥25 kg/m^2） and 3583 patients in the low BMI group （BMI 〈25 kg/m^2）. Compared with the low BMI group, the high BMI group were associated with longer operation time （SMD=0.64, 95%CI：0.35-0.93, P=0.000）, more intraoperative blood loss （SMD=0.63, 95%CI：0.24-1.03, P=0.002）, less retrieved lymph nodes （SMD=-0.44, 95%CI：-0.72--0.17, P=0.002）, and more postoperative complications （OR=1.44, 95%CI：1.19-1.74, P=0.000）. There were no significant differences in postoperative hospital stay, the time to first flatus and initial complication （P〉0.05）. Conclusion The higher BMI may result in a longer operation time, more intraoperative blood loss and a higher rate of postoperative complication after laparoscopy radical gastrectomy.

关 键 词：体质指数 腹腔镜 胃肿瘤 胃切除术 META分析 

分 类 号：R735.2[医药卫生—肿瘤]