国内全膀胱切除术后不同尿流改道术式临床疗效的Meta分析  

Clinical efficacy of ileal conduit vs. orthotropic ileal neobladder:A Meta-analysis

作　　者：何俊[1] 王海峰 王剑松[1] 

机构地区：[1]昆明医科大学第二附属医院泌尿外科,云南省泌尿外科研究所,云南昆明650101

出　　处：《现代泌尿外科杂志》2016年第11期828-833,共6页Journal of Modern Urology

基　　金：国家自然科学基金(No.81260374,81460384);云南省教育厅基金(No.2014Z072);云南省科技厅面上项目(No.2015FB196);云南省科技厅-昆明医科大学联合专项(No.2014FA015,2014FZ031);云南省卫生厅内设机构项目(No.2014NS081)

摘　　要：目的应用Meta分析方法系统评价国内全膀胱切除术后不同尿流改道术式的临床疗效。方法计算机检索中国知网、万方数据知识服务平台、维普期刊资源整合服务平台、中国生物医学文献数据库搜集膀胱癌的患者进行全膀胱切除术联合不同尿流改道术式,检索时限均为从建库至2016年3月。制定纳入和排出标准,查找文献,客观评价偏倚风险,提取最终纳入的文献的数据,使用RevMan 5.3软件进行Meta分析。结果本项研究共有1 115例进行全膀胱切除术不同尿流改道术式入选,通过Meta分析结果显示,与原位回肠新膀胱组相比,回肠流出道术组手术时间[MD=-27.67,95%CI:-48.69^-6.65,P=0.010)、肠胃功能恢复时间[MD=-2.62,95%CI(-4.30^-0.94),P=0.002]、住院时间(MD=-3.19,95%CI:-4.97^-1.41,P=0.000 5)均较短。但在术中出血量和早期并发症发生率差异无统计学意义。结论回肠流出道术组在肠胃功能恢复时间、住院时间、手术时间几个方面要优于原位回肠新膀胱组,同时期望更多高质量研究来验证上述结论。Objective To systematically review the clinical efficacy of ileal conduit and orthotropic ileal neobladder using Meta-analysis. Methods CNKI, Wanfang, VIP and Chinese Biomedical Literature Database were searched to collect clinical trials about urinary diversion in bladder cancer from the inception of databases to Jan. 2016. The literatures were screened, da- ta were extracted, and the risk of bias was assessed. Meta-analysis was performed using RevMan 5.3 software. Results A to- tal of 1 115 patients were included. The results of Meta-analysis showed that compared with the orthotropic ileal neobladder group, the ileal conduit group needed significantly shorter operation time （ MD = - 27.67, 95% CI ： - 48.69- - 6.65, P = 0. 010）, recovery time of gastrointestinal function （ MD = - 2.62, 95 M CI ：- 4.30- - 0.94, P = 0. 002）, and hospital stay （MD = -3.19, 95% CI ： -4.97- - 1.41, P = 0. 000 5）. However, no significant differences were found in blood loss and early complication rate between the two groups. Conclusion Ileal conduit is better than orthotopic ileal neobladder in terms of opera- tion time, recovery time of gastrointestinal function and hospital stay. More high quality studies are needed to verify the above conclu- sion.

关 键 词：尿流改道 全膀胱切除术 回肠流出道术 原位回肠新膀胱术 META分析 

分 类 号：R737.14[医药卫生—肿瘤]