3D打印技术辅助腹腔镜下肾部分切除术疗效的Meta分析  

Meta-analysis of the efficacy of laparoscopic partial nephrectomy assisted by 3Dprinting technology

作　　者：范宁[1] 张丽秀[2] 冯彬[3] 丁辉[1] 陶燕[1] 岳中瑾[1] 王志平[1] FAN Ning;ZHANG Lixiu;FENG Bin;DING Hui;TAO Yan;YUE Zhongjin;WANG Zhiping(Department of Urology,Second Hospital of Lanzhou University,Key Laboratory for Urological Diseases of Gansu Province,Clinical Center for Nephro-Urology of Gansu Province,Lanzhou,730030,China;Department of Clinical Laboratory Center,Gansu Provincial Maternity and Child-Care Hospital;Department of Urology,Gansu Provincial People's Hospital)

机构地区：[1]兰州大学第二医院泌尿外科甘肃省泌尿系统疾病研究重点实验室,甘肃省泌尿系统疾病临床医学中心,兰州730030 [2]甘肃省妇幼保健院临床检验中心 [3]甘肃省人民医院泌尿外科

出　　处：《临床泌尿外科杂志》2021年第7期560-566,共7页Journal of Clinical Urology

基　　金：兰州大学第二医院萃英科技创新计划(No:2020QN-17)。

摘　　要：目的:比较3D打印技术辅助腹腔镜下肾部分切除术与传统腹腔镜肾部分切除术治疗肾肿瘤的疗效。方法:检索各大数据库相关文献,由2名独立文献分析员进行质量评价及数据提取,利用Revman 5.3软件进行分析。结果:共纳入文献9篇,共计病例511例。与传统腹腔镜肾部分切除术相比,3D打印技术辅助腹腔镜下肾部分切除术手术时间[MD=-10.73,95%CI(-16.76,-4.70),P=0.000 5]及血流阻断时间[MD=-4.03,95%CI(-5.38,-2.69),P<0.000 01]更短,术中出血量更少[MD=-15.64,95%CI(-26.05,-5.23),P=0.003],并发症更少[OR=0.37,95%CI(0.21,0.67),P=0.001],切缘宽度更小[MD=-0.12,95%CI(-0.20,-0.04),P=0.004],住院时间更短[MD=-0.15,95%CI(-0.30,-0.01),P=0.04],在术后1个月肌酐[MD=0.14,95%CI(-0.63,0.92),P=0.72]、切缘阳性率[RD=-0.01,95%CI(-0.04,0.03),P=0.67]和胃肠功能恢复时间[MD=-0.10,95%CI(-0.24,0.04),P=0.14]方面两者效果相当。结论:与传统腹腔镜肾部分切除术相比,3D打印技术辅助腹腔镜下肾部分切除术能够缩短手术时间、减少血流阻断时间及术中出血量、降低并发症的发生、缩小切缘宽度、减少术后住院时间,在术后1个月血肌酐、切缘阳性和胃肠功能恢复时间上效果相当。但由于本研究纳入文献较少且质量不高,各研究之间异质性较大,需要更多高质量的随机对照研究以进一步证实该结论。Objective: To compare the efficacy between laparoscopic partial nephrectomy assisted by 3 D printing technique and conventional laparoscopic partial nephrectomy in the treatment of renal tumors. Methods: The related literature of major databases was ready for retrieval by two independent literature analysts, then quality evaluation and data extraction were conducted. Revman 5.3 software was used to analyze the data. Results: A total of 9 articles were included, with a total of 511 cases. Compared with traditional laparoscopic partial nephrectomy, 3 D printing technology assisted laparoscopic partial nephrectomy has shorter operation time[MD=-10.73, 95%CI(-16.76,-4.70), P=0.000 5]and blood flow blocking time[MD=-4.03, 95%CI(-5.38,-2.69), P<0.000 01], less intraoperative blood loss[MD=-15.64, 95%CI(-26.05,-5.23), P=0.003], fewer complications[OR=0.37, 95%CI(0.21, 0.67), P=0.001], smaller resection margin width[MD=-0.12, 95%CI(-0.20,-0.04), P=0.004], shorter hospital stay[MD=-0.15, 95%CI(-0.30,-0.01), P=0.04], and equivalent results in terms of postoperative creatinine[MD=0.14, 95%CI(-0.63, 0.92), P=0.72], positive rate of resection margin[RD=-0.01, 95%CI(-0.04, 0.03), P=0.67], and recovery time of gastrointestinal function[MD=-0.10, 95%CI(-0.24, 0.04), P=0.14]. Conclusion: Compared with traditional laparoscopic partial nephrectomy, laparoscopic partial nephrectomy assisted by 3 D printing technology can shorten operation time, reduce blood flow blocking time and intraoperative bleeding, reduce the incidence of complications, reduce the width of resection margin, reduce postoperative hospital stay, and has equivalent effect in terms of postoperative creatinine, positive resection margin and recovery time of gastrointestinal function. However, due to the small number and low quality of included literature in this study and the heterogeneity among studies, more high-quality randomized controlled studies are needed to further confirm this conclusion.

关 键 词：3D打印 腹腔镜 保留肾单位 肾部分切除术 肾肿瘤 META分析 

分 类 号：R737.11[医药卫生—肿瘤]