3D与2D腹腔镜直肠癌根治术近期疗效的Meta分析  

The short-term efficacy of 3D versus 2D laparoscopic radical resection for rectal cancer: A meta analysis

作　　者：李来元 张维胜[1] 冯丽莉[1] 王涛[1] 赵红军[2] 段耀星[1] 燕东[1] 果茵茵[3] 杨熊飞[1] Li Laiyuan;Zhang Weisheng;Feng Lili;Wang Tao;Zhao Hongjun;Duan Yaoxing;Yan Dong;Guo Yinyin;Yang Xiongfei(Anorectal Department,Gansu Provincal Hospital,Lanzhou 730000,China;Gansu Provincial Center for Disease Control and Prevention,Institute of Chronic Diseases,Lanzhou 730020,China;Department of Pharmacy,Lanzhou University Second Hospital,Lanzhou 730050,China)

机构地区：[1]甘肃省人民医院肛肠科,兰州730000 [2]甘肃省疾病预防控制中心慢病所,兰州730020 [3]兰州大学第二医院药剂科,730050

出　　处：《中华结直肠疾病电子杂志》2020年第1期61-67,共7页Chinese Journal of Colorectal Diseases(Electronic Edition)

基　　金：甘肃省科技计划项目(No.18JR3RA05)

摘　　要：目的系统评价3D与2D腹腔镜在直肠癌根治术的近期临床疗效。方法计算机检索PubMed、The Cochrane Library、Web of Science、Embase、CNKI、WanFang和VIP国内外数据库中比较3D与2D腹腔镜直肠癌根治术近期疗效的文献,并搜集相关文献的参考文献,检索时间从数据库建立至2019年3月1日。运用Review Manager 5.2软件对相关指标进行Meta分析。结果最终纳入11个研究,包含2个随机对照研究(RCT),9个非RCT,共1 169例患者纳入分析,其中3D腹腔镜组601例,2D腹腔镜组568例。3D腹腔镜组术中出血量(P<0.00001)、手术时间(P<0.00001)、首次排气时间(P<0.0001)、住院时间(P=0.04)、并发症发生率(P=0.04)、淋巴结获取数目(P<0.00001)均优于2D腹腔镜组,差异有统计学意义。两组中转开腹、环周切缘(CRM)阳性率比较,差异无统计学意义(P>0.05)。手术时间的漏斗图提示无发表偏倚(P=0.693)。结论与2D腹腔镜直肠癌手术相比,3D腹腔镜同样能够达到直肠癌根治性切除,且具有手术时间短、术中失血量少、术后并发症低、住院时间短、清扫淋巴结数目多等优势。Objective To systematically review the short-term clinical efficacy of 3D versus 2D laparoscopic radical resection for rectal cancer.Methods Such databases as PubMed,The Cochrane Library,Web of Science,EMbase,CNKI,WanFang and VIP were electronically searched for published articles at home and abroad on the short-term clinical efficacy of 3D versus 2D laparoscopic radical resection for rectal cancer from the database establishment to March 1st,2019,and collected relevant literature references.Meta-analysis was performed using RevMan 5.2 software.Results A total of 1169 patients were included in 11 studies(2 randomized controlled trials,RCTs,9 nRCTs),including 601 patients in the 3D laparoscopic group and 568 patients in the 2D laparoscopic group.Blood loss(P<0.00001),operation time(P<0.00001),first flatu(P<0.0001),hospital stay(P=0.04),incidence of complications(P=0.04),harvested lymph node(P<0.00001)in the 3D laparoscopic group were all better than those in the 2D laparoscopic group,with statistically significant differences.However,no differences were observed in conversion rate and circumferential resection margin(CRM)positive rate(P>0.05).There was no evidence of publication bias in studies used for operation time(P=0.693).Conclusion Compared with 2D laparoscopic rectal cancer surgery,3D laparoscopic surgery can also achieve radical resection of rectal cancer,and has the advantages of shorter operation time,less intraoperative blood loss,lower postoperative complications,shorter hospital stay,and more harvested lymph node.

关 键 词：直肠肿瘤 腹腔镜 3D 2D META分析 

分 类 号：R735.37[医药卫生—肿瘤]