摘要
目的系统比较围肝门切除术与联合肝切除术对肝门部胆管癌患者的预后差异。方法计算机检索PubMed、SCI、OVID、CBM、中国知网(CNKI)、维普和万方数据库,收集1999年1月1日—2020年1月30日之间公开发表的有关围肝门切除术与联合肝切除术治疗肝门部胆管癌的研究论文,并应用RevMan5.3软件进行Meta分析。结果最终纳入文献12篇,样本量共1289例,其中围肝门切除组427例,联合肝切除组862例。Meta分析结果显示围肝门切除组的根治切除率为46.71%,联合肝切除组为79.60%,围肝门切除组明显低于联合肝切除组(RR=0.55,95%CI 0.40~0.74,P=0.0001)。围肝门切除组术后并发症发生率为21.81%,联合肝切除组为42.29%,2组术后并发症发生率差异有统计学意义(RR=0.63,95%CI 0.49~0.81,P=0.0003)。2组患者术后1,2,3年的总体生存率差异均有统计学意义(P<0.01)。结论肝门部胆管癌联合肝切除术的根治性切除率和患者术后生存率比围肝门切除术高,但手术并发症风险高。
Objective To systematically compare prognosis of perihilar resection versus hepatectomy combined in the treatment of hilar cholangiocarcinoma.Methods The randomized controlled trials or non randomized controlled trials on perihilar resection and hepatectomy combined for treatment of Hilar Cholangiocarcinoma were searched from databases of PubMed,Web of Science,OVID,CBM,CNKI,VIP and Wangfang data.The search period was from January 1,1999 to January 30,2020.The RevMan 5.3 software was used for data analysis.Results A total of 12 studies including 1289 cases were analyzed.A total of 427 patients received perihilar resection.There were 862 cases received hepatectomy combined.The results of meta-analysis showed that radical resection rate in perihilar resection group and hepatectomy combined group were 46.71%and 79.60%.Radical resection rate and postoperative complication rate in perihilar resection group were lower than those in hepatectomy combined group(RR=0.55,95%CI 0.40~0.74,P=0.0001;RR=0.63,95%CI 0.49~0.81,P=0.0003).There was statistically significant difference in survival rate of the 1,2,and 3 years between the two groups(P<0.01).Conclusion Our results indicated that hepatectomy combined is superior to perihilar resection in radical resection and survival for hilar cholangiocarcinoma,but the risk of surgical complications was high.
作者
李晓珍
夏婉婷
陆路
王太成
Li Xiaozhen;Xia Wanting;Lu Lu(The School of Public Health of Hainan Medical University,Haikou,Hainan571199;The Second Affiliated Hospital of Hainan Medical University,Haikou,Hainan570100)
出处
《基层医学论坛》
2022年第13期11-15,共5页
The Medical Forum
