单孔腹腔镜用于腹腔镜脾切除的Meta分析  

Single-incision laparoscopic splenectomy： a Meta-analysis

作　　者：余海波 马帅 郝晓沛 董亚东 王连才 田广金 李德宇 

机构地区：[1]河南省人民医院郑州大学人民医院肝胆外科,郑州450003

出　　处：《中华肝胆外科杂志》2018年第2期109-112,共4页Chinese Journal of Hepatobiliary Surgery

基　　金：河南省基础与前沿技术项目（112300410037）;河南省重点科技攻关计划项目（132102310385）;郑州市重点实验室项目（2015-9-23）

摘　　要：目的探讨单孔腹腔镜脾切除术（SILS）临床应用的安全性和有效性。方法检索Cochrane、Medline、SCI、EMBASE、中国知网、万方数据库和中国生物医学数据库等数据库比较SILS和标准腹腔镜脾切除（LS）的研究资料。对纳入文献进行质量评价和数据提取，使用Revman5．0软件进行Meta分析。结果分析最终共纳入9项研究、259例患者。其中109例行SILS，150例行Ls。结果显示SILS组的手术时间不超过LS组[RR，-4．66；95％CI，-53．02～43．70；P〉0．05]。SILS组术中估计出血量不超过LS组[RR，-14．94；95％C1，-64．93～35．06；P〉0．05]。SILS组术后禁食时间与LS组差异无统计学意义[RR，-0．13；95％CI，-0．8～0．54；P〉0．05]。SILS组与Ls组患者的术后住院时间之间差异无统计学意义。结论Meta分析表明，SILS与LS一样，是一种安全、有效的微创手术。现有的证据表明，SILS可以用作常规的脾切除术。Objective To explore security and efficacy of single-incision laparoscopic splenectomy （SILS）. Methods All the studies comparing SILS and laparoscopic splenectomy （LS） for splenic resection were searched on the available databases including the Cochrane Central Register of Controlled Trials, Med- line, Science Citation Index, EMBASE, China National Knowledge Infrastructure, Wanfang Database and China Biomedical Database. The data were analyzed using the Review Manager Software version 5.0. Re- suits After the literature search, nine studies were included in the meta-analysis, which involved 259 pa- tients ： 109 in the SILS group and 150 in the LS group. The operative time in the SILS group was not signifi- cantly longer than the LS group （RR, - 4.66 ; 95 % CI, - 53.02 to 43.70 ; P 〉 0.05 ）. The estimated in- traoperative blood loss in the SILS group was not significantly more than the LS group （RR, -14.94; 95% CI, -64.93 to 35.06; P 〉0.05）. The time of oral intake in the SILS group was the same as in the LS group （RR, -0.13; 95% CI, -0.8 to 0.54; P 〉 0.05）. The time of postoperative hospital stay in the SILS group was the same as in the LS group （RR, -0.83 ; 95% CI, - 1.98 to 0.31 ; P 〉0.05）. Conclu- sions This meta-analysis demonstrated that SILS was as safe, effective, and minimally invasive as LS. The current evidence suggested that it could be used routinely in splenic resection.

关 键 词：腹腔镜 脾切除术 单孔腹腔镜 META分析 

分 类 号：R657.6[医药卫生—外科学]