经口腔前庭入路与经全乳晕入路腔镜治疗甲状腺乳头状癌的疗效和安全性的Meta分析  

Efficacy and safety of endoscope for treating thyroid papillary carcinoma via oral vestibular versus via whole areola approaches:a study of Meta-analysis

作　　者：王加中[1] 曹罡[1] 刘阳[1] 陈硕[1] WANG Jiazhong;CAO Gang;LIU Yang;CHEN Shuo(Department of General Surgery,the Second Affiliated Hospital of Xi'an Jiaotong University,Xi'an 710061,Shaanxi,China)

机构地区：[1]西安交通大学第二附属医院普通外科,陕西省西安市710061

出　　处：《广西医学》2023年第2期187-191,共5页Guangxi Medical Journal

基　　金：陕西省自然科学基础研究计划项目(2020JM-404)。

摘　　要：目的系统评价经口腔前庭入路与经全乳晕入路腔镜手术治疗甲状腺乳头状癌的疗效和安全性。方法通过中国知网、中国生物医学文献数据库、万方数据库、PubMed、EMBASE、MEDLINE、SpringerLink、John Wiley、Ovid?、Cochrane Library等数据库,以及Google Scholar搜索引擎平台,检索经口腔前庭入路与经全乳晕入路腔镜手术治疗甲状腺乳头状癌的相关文献。筛选文献后对文献进行偏倚风险评估,采用RevMan 5.4统计软件进行Meta分析。结果共纳入7篇文献,共595例患者。Meta分析结果显示,经口腔前庭入路腔镜甲状腺乳头状癌手术的淋巴结清扫数目多于经全乳晕入路,术中出血量少于经全乳晕入路(均P<0.05),而两种入路腔镜甲状腺乳头状癌手术的手术时间及手术并发症发生率的比较,差异均无统计学意义(均P>0.05)。结论相较于经全乳晕入路,经口腔前庭入路进行腔镜甲状腺乳头状癌手术具有淋巴结清扫数目多、术中出血量少的优点,同时不增加手术时间及手术并发症发生率。Objective To systematically evaluate the efficacy and safety of endoscope for the treatment of papillary thyroid carcinoma via oral vestibular versus via whole areola approaches.Methods Literature related to endoscopic surgery for the treatment of thyroid papillary carcinoma via oral vestibular approach versus via whole areola approach was retrieved through databases of China National Knowledge Infrastructure,China Biology Medicine,Wanfang Database,PubMed,EMBASE,MEDLINE,SpringerLink,John Wiley,Ovid?,Cochrane Library,etc.as well as Google Scholar search engine platform.After literature screening,bias risk assessment was performed on the literature,and Meta-analysis was performed by using RevMan 5.4 statistical software.Results A total of 595 patients were included in 7 literature.The results of Meta-analysis showed that the number of lymph nodes dissection by endoscopic surgery of thyroid papillary carcinoma via oral vestibular approach was more than that via whole areola approach,and intraoperative bleeding volume was less than that via whole areola approach(all P<0.05),whereas there was no statistically significant difference in operation duration and the incidence rate of operative complications between the endoscopic surgery of thyroid papillary carcinoma via oral vestibular approach and via whole areola approach(all P>0.05).Conclusion Compared with via whole areola approach,endoscopic surgery of thyroid papillary carcinoma via oral vestibular approach has the advantages of more number of lymph nodes dissection,and less intraoperative bleeding volume.At the same time,it does not increase operation duration and the incidence rate of operative complications.

关 键 词：甲状腺乳头状癌 腔镜手术 手术入路 淋巴结清扫 术中出血 手术时间 手术并发症 系统评价 

分 类 号：R653[医药卫生—外科学] R736.1[医药卫生—临床医学]