摘要
目的系统评价腹腔镜手术与开腹手术治疗直肠癌的疗效对比。方法检索Pub Med、EMBASE、Cochrane Library、CNKI和万方数据库。检索日期为各数据库建库至2015年6月1日。最终纳入腹腔镜手术与开腹手术治疗直肠癌相关文献共10篇进行Meta分析。结果共纳入病例3 237例,其中腹腔镜手术组1 783例,开腹手术组1 454例。Meta分析结果:与开腹手术相比,腹腔镜手术时间延长(MD=33.33,95%CI:29.81~36.85,P<0.05),但术后肠功能恢复时间更短(MD=-1.43,95%CI:-1.78~1.08,P<0.05),术后相关并发症更少(OR=0.60,95%CI:0.50~0.73,P<0.05);两组在淋巴结检出数量(MD=-0.46,95%CI:-1.11~0.19,P>0.05)、肿瘤距远切缘距离(MD=0.12,95%CI:-0.12~0.35,P>0.05)、环周切缘阳性率(OR=0.88,95%CI:0.58~1.33,P>0.05)以及术后5年无疾病生存期(OR=1.18,95%CI:0.83~1.69,P>0.05)方面无统计学差异,在术后5年总生存率(OR=1.988,95%CI:1.52~2.57,P<0.05)方面,腹腔镜手术优于开腹手术。结论直肠癌腹腔镜手术术后短期恢复上明显优于开腹手术,且在肿瘤学方面不次于开腹手术。
Objective To review the short- and long- term outcomes after laparoscopic surgery for rectal cancer. Methods Electronic literature search was performed on Pub Med,EMBASE,Cochrane Library,CNKI and Wanfang database from inception to Jun 1,2015. Finally we got10 literatures focused on the comparison of the laparoscopic and open surgery for rectal cancer to review. Results Among all the 10 included studies,a total of 3237 cases were reported,including 1783 patients in the laparoscopic surgery group and 1454 patients in the open surgery group. The results of the meta- analysis showed that despite longer operation times（ MD = 33. 33,95% CI： 29. 81 ~ 36. 85,P 0. 05）,there were significantly shorter times to bowel function recovery（ MD =- 1. 43,95% CI：- 1. 78 ^- 1. 08,P 0. 05）,fewer complications（ OR = 0. 60,95% CI： 0. 50 ~ 0. 73,P 0. 05） in the laparoscopic surgery group. The compared results of the lymph node harvest number（ MD =- 0. 46,95% CI：- 1. 11 ~ 0. 19,P 0. 05）,distal resection margin（ MD = 0. 12,95% CI：- 0. 12 ~ 0. 35,P 0. 05）,circumferential resection margin involvement（ OR = 0. 88,95%CI： 0. 58- 1. 33,P 0. 05）,5- years disease- free survival（ OR = 1. 18,95% CI： 0. 83- 1. 69,P 0. 05） were similar between both groups.But in the five year survival rate,the laparoscopic surgery group was superior to open surgery group. Conclusion Laparoscopic surgery for rectal cancer was significantly better than that of open surgery. And this method was not inferior to open operation in oncology.
出处
《临床和实验医学杂志》
2015年第16期1367-1372,共6页
Journal of Clinical and Experimental Medicine
