摘要
目的评价经腹途径腹腔镜去顶减压术与经腹膜后途径腹腔镜去顶减压术治疗单纯性肾囊肿的临床疗效。方法检索PubMed、EMBASE、Cochrane Library、中国知网、维普、万方等数据库中有关经腹途径与经腹膜后途径腹腔镜去顶减压术治疗单纯性肾囊肿的对照研究,评价指标包括手术时间、术中出血量、术后引流时间、术后住院时间及并发症发生率。采用RevMan 5.3软件对数据进行统计学分析。结果共纳入14篇对照研究,经腹途径组409例,经腹膜后途径组452例。Meta分析显示,经腹膜后途径组患者的手术时间(MD=8.81,95%CI:3.79~13.82,P<0.01)、术中出血量(MD=4.89,95%CI:1.40~8.38,P<0.01)以及术后住院时间(MD=0.60,95%CI:0.24~0.96,P<0.01)均低于经腹途径组,差异均具有统计学意义;而两组患者的术后引流时间(MD=-0.12,95%CI:-0.26~0.03,P=0.13)和并发症发生率(OR=1.47,95%CI:0.48~4.47,P=0.05)比较,差异均无统计学意义。结论与经腹途径相比,经腹膜后途径腹腔镜去顶减压术具有手术时间短、术中出血量少和术后住院时间短等优点,因此,经腹膜后途径腹腔镜去顶减压术有望成为治疗单纯性肾囊肿的首选方法。
Objective To evaluate the clinical effects of transperitoneal and retroperitoneal laparoscopic decortication in the treatment of simple renal cysts.Methods PubMed,EMBASE,Cochrane Library,CNKI,VIP and WanFang databases were searched,All studies about comparing transperitoneal and retroperitoneal laparoscopic decortication for simple renal cysts were included.The evaluation indicators included operative time,intraoperative blood loss,postoperative drainage time,postoperative hospital stay,and complication rate.Statistical analysis of the data using RevMan 5.3 software.Results A total of 14 control studies were included,409 cases in the transperitoneal group and 452 cases in the retroperitoneal group.Meta-analysis demonstrated that compared with the transperitoneal group,the retroperitoneal group had shorter operation time(MD=8.81,95%CI:3.79-13.82,P<0.01),less intraoperative blood loss(MD=4.89,95%CI:1.40-8.38,P<0.01),and shorter postoperative hospital stay(MD=0.60,95%CI:0.24-0.96,P<0.01).However,there were not significant differences between the two approaches in postoperative drainage time(MD=-0.12,95%CI:-0.26-0.03,P=0.13)and complication rate(OR=1.47,95%CI:0.48-4.47,P=0.05).Conclusions Compared with the transperitoneal,the retroperitoneal laparoscopic decortication has the advantages of short operation time,less intraoperative blood loss and short postoperative hospital stay.Therefore,retroperitoneal laparoscopic decortication is expected to be the first choice for the treatment of simple renal cysts.
作者
李金泽
彭磊
李云祥
蒙春扬
曹德宏
Li Jinze;Peng Lei;Li Yunxiang;Meng Chunyang;Cao Dehong(Department of Urology,The Affiliated Nanchong Central Hospital of North Sichuan Medical College,Nanchong 637000,China;Department of Urology,West China Hospital,Sichuan University,Institute of Urology,Chengdu 610041,China)
出处
《国际外科学杂志》
2020年第9期604-609,F0004,共7页
International Journal of Surgery
