内镜下切除与开腹手术治疗胃内胃肠道间质瘤的有效性和安全性的Meta分析  

Efficacy and safety of endoscopic resection and laparotomy in treatment of gastric gastrointestinal stromal tumor: a Meta-analysis

作　　者：李梦颖[1] 喻军[1] 谢扬[1] 齐健[1] LI Mengying;YU Jun;XIE Yang;QI Jian(Department of Gastroenterology,Zhongnan Hospital of Wuhan University,Clinical Research Center of Enteropathy Mecli-cine in Hubei Province,the Hubei Clinical Center ＆ Key Laboratory of Intestinal ＆ Colorectal Diseases,Wuhan 430000,Chin)

机构地区：[1]武汉大学中南医院消化内科、武汉大学第二临床学院、湖北省肠病医学临床研究中心、肠病湖北省重点实验室,湖北武汉430000

出　　处：《胃肠病学和肝病学杂志》2018年第8期915-921,共7页Chinese Journal of Gastroenterology and Hepatology

基　　金：国家青年基金(81101868);武汉市科技局应用基础研究计划项目(2015061701011642)

摘　　要：目的系统评价内镜下切除与开腹手术治疗胃内胃肠道间质瘤的有效性及安全性,以期为临床决策提供参考。方法计算机检索Pub Med、Embase、Cochrane Library、中国生物医学文献数据库、中国知网、万方数据库等数据库,全面收集内镜下切除和开腹手术两种治疗胃内胃肠道间质瘤的随机对照试验和非随机对照试验,在文献筛选、资料提取和文献质量评价后,采用Stata 12.0软件进行Meta分析。结果共纳入5篇回顾性队列研究,研究对象共400例。Meta分析结果显示:内镜组较开腹手术组的手术时间更短(SMD=-2.54,95%CI:-4.42^-0.67,P=0.008),术中出血量更少(SMD=-4.18,95%CI:-5.59^-2.41,P=0.000)。两种治疗方式在术后住院天数(SMD=-1.13,95%CI:-2.45~0.18)、术后并发症(RR=1.13,95%CI:0.55~2.33)、住院费用(SMD=-1.91,95%CI:-4.59~0.77)和手术后复发转移(RR=0.42,95%CI:0.06~3.02)等方面相比,差异无统计学意义(P>0.05)。结论与开腹手术相比,胃内胃肠道间质瘤行内镜下切除是安全有效的。Objective To systematically review the efficacy and safety of endoscopic resection and laprotomy in treatment of gastric gastrointestinal stromal tumor. Methods Databases such as Pub Med,Embase,Cochrane Library,CBM,CNKI and Wan Fang Data were searched to comprehensively collect the randomized and non-randomized controlled trials that compared between endoscopy and laprotomy in treatment of gastric gastrointestinal stromal tumor. After literature screening,data extraction and literature quality evaluation,a Meta analysis was performed by Stata 12. 0 software.Results Five studies with 400 patients were enrolled,all of the studies were retrospectively analyzed. The Meta-analysis results showed that,compared with laprotomy group,the endoscopy group required the less time（SMD =-2. 54,95%CI：-4. 42--0. 67,P = 0. 008） and intraoperation blood loss（SMD =-4. 18,95% CI：-5. 59--2. 41,P =0. 000）. There were no significant differences in postoperative hospital stay（SMD =-1. 13,95% CI：-2. 45-0. 18）,postoperative complication（RR = 1. 13,95% CI： 0. 55-2. 33）,hospitalization expenses（SMD =-1. 91,95% CI：-4. 59-0. 77）,metastasis and recurrence after surgery（RR = 0. 42,95% CI： 0. 06-3. 02） between two treatment techniques（P 0. 05）. Conclusion Compared with surgery,endoscopy is safe and effective for the gastric gastrointestinal stromal tumor.

关 键 词：胃肠道间质瘤 内镜 开腹手术 系统评价 META分析 

分 类 号：R735.2[医药卫生—肿瘤]