开放性手术与腹腔镜手术治疗肾上腺肿瘤的效果的meta分析  

Comparison of open versus laparoscopic surgeries for adrenal tumor: a meta-analysis

作　　者：林茂虎[1] 朱晓应[1] 苗芮[1] 何蕾[2] 贾宁[3] 

机构地区：[1]解放军总医院第一附属医院泌尿外科,北京100051 [2]解放军总医院肝胆外科,北京100853 [3]解放军总医院感染管理与疾病控制科,北京100853

出　　处：《南方医科大学学报》2016年第11期1582-1588,共7页Journal of Southern Medical University

基　　金：国家自然科学基金(30972523;31140046)~~

摘　　要：目的通过对开放性手术与腹腔镜手术在治疗肾上腺肿瘤效果的系统评价,比较两种方法的有效性与安全性。方法计算机检索CNKI,PUBMED,Sino Med,EBSCO,Springerlink,万方医学网,维普数据库等相关数据库,全面收集1999年-2016年发表的相关文献,对文章进行筛选、评价以及提取相关资料,运用Rev Man5.2软件进行Meta分析。结果纳入的25篇文章,共有2340例患者,Meta分析结果显示,在术后肠功能恢复时间[OR=-0.96,95%CI（-1.22,-0.70）P〈0.00 001],住院时间[OR=-3.48,95%CI（-4.13,-2.78）P〈0.00 001],术后并发症[OR=0.22,95%CI（0.14,0.35）P〈0.00 001],术中出血量（OR=-104.77,95%CI（-138.95,-70.60）P〈0.00 001）方面腹腔镜手术优于开放性手术;在手术时间、手术费用的比较中,两组差异没有统计学意义。结论腹腔镜手术在术后肠功能恢复时间、住院时间、术后并发症和术中出血上优于开放性手术,但在手术时间、手术花费方面差异不明显。Objective To systematically review the effectiveness and safety of open and laparoscopic surgeries for treatment of adrenal tumors. Methods The online databases including CNKI, PUBMED, Sino Med, EBSCO, Springerlink, Wan Fang Data,and VIP were searched for clinical trials published from 1999 to 2016. A meta-analysis was performed using Rev Man 5.2software. Results A total of 2340 patients in 25 trials were included. The results of meta-analysis showed that laparoscopic surgery was better than open surgery in terms of intestinal function recovery time（OR=-0.96, 95%CI [-1.22,-0.70] P〈0.000 01）,hospitalization time（OR=-3.48, 95% CI [-4.13,-2.78], P〈0.000 01）, complications（OR=0.22, 95% CI [0.14, 0.35], P〈0.0001）, and volume of blood loss（OR=-104.77, 95%CI [-138.95,-70.60], P〈0.000 01）. There was no significant difference in the surgery cost between open and laparoscopic surgeries. Conclusion Laparoscopic surgery is superior to open surgery for treatment of adrenal tumors for shorter intestinal function recovery time, surgery duration, and hospitalization time and less complications and blood loss.

关 键 词：腹腔镜手术 开放性手术 肾上腺肿瘤 META分析 

分 类 号：R736.6[医药卫生—肿瘤]