腹腔镜与开放手术治疗双侧腹股沟疝疗效及安全性的meta分析  

Efficacy and safety of laparoscopy and open surgery for bilateral inguinal hernia:a meta-analysis

作　　者：张迪[1] 赖建勤 黄华平 陈程 罗迦耀 龚瑾[1] ZHANG Di;LAI Jian-qin;HUANG Hua-ping(Department of Gastrointestinal Surgery,the First Affiliated Hospital of Jinan University,Guangzhou 510630,China)

机构地区：[1]暨南大学附属第一医院胃肠外科,广东广州510630

出　　处：《腹腔镜外科杂志》2020年第12期881-888,共8页Journal of Laparoscopic Surgery

摘　　要：目的:评价腹腔镜与开放手术治疗双侧腹股沟疝的疗效及安全性。方法:检索PubMed、Embase、Cochrane Library、万方医学、中国知网等电子数据库,按照纳入与排除标准筛选文献后,使用Cochrane手册及纽卡斯尔-渥太华量表文献质量评价量表进行文献质量评价,采用Review Manager 5.3软件进行效应量的合并分析。结果:最终纳入12篇文献,共1 466例患者。Meta分析结果显示,两组手术时间、复发率、切口血清肿发生率、术后腹股沟区感觉异常发生率、术后阴囊肿胀发生率差异无统计学意义,但腹腔镜组住院时间更短[SMD=-2.89,95%CI(-4.06,-1.72),P<0.00001],术后腹股沟慢性疼痛发生率[OR=0.16,95%CI(0.06,0.45),P=0.0004]、切口血肿发生率[OR=0.25,95%CI(0.13,0.49),P<0.0001]、切口感染率[OR=0.14,95%CI(0.04,0.46),P=0.001]、术后尿潴留发生率[OR=0.25,95%CI(0.12,0.52),P=0.0002]更低。结论:对于双侧腹股沟疝,相较开放疝修补术,腹腔镜修补术可缩短住院时间,降低术后并发症发生率,提高患者术后舒适感,改善生活质量。Objective:To evaluate the efficacy and safety of laparoscopic and open hernia repair in bilateral inguinal hernia.Methods:A comprehensive search was performed in PubMed,Embase,Cochrane Library,WanFang and CNKI databases.After screening according to the inclusion and exclusion criteria,the quality of included studies was evaluated by the Cochrane Handbook bias risk assessment tools and the Newcastle-Ottawa scale.The test data was extracted and then meta-analyzed by RevMan 5.3 software.Results:Twelve studies including 1466 patients were considered for the final analysis.The pooled results showed that there was no statistical difference in operative time,recurrence,incision seroma,postoperative groin sensory abnormality and postoperative scrotal swelling between two groups(P>0.05);However,the postoperative hospitalization time[SMD=-2.89,95%CI(-4.06,-1.72),P<0.00001],the incidence of chronic groin pain[OR=0.16,95%CI(0.06,0.45),P=0.0004],incisional hematoma[OR=0.25,95%CI(0.13,0.49),P<0.0001],incision infection[OR=0.14,95%CI(0.04,0.46),P=0.001]and urinary retention[OR=0.25,95%CI(0.12,0.52),P=0.0002]were significantly lower in laparoscopy group compared with open group.Conclusions:Compared with the open hernia repair,laparoscopic repair has the advantages of shortening the hospital stay,reducing postoperative complications and improving the postoperative comfort and quality of life in patients with bilateral inguinal hernia.

关 键 词：疝 腹股沟 疝修补术 腹腔镜检查 开放手术 META分析 

分 类 号：R656.21[医药卫生—外科学]