腹腔镜与开腹远端胃切除术后手术部位感染的Meta分析

Comparison of surgical site infection between laparoscopic distal gastrectomy and open distal gastrectomy for gastric cancer: A Meta-analysis

摘要:

目的   比较腹腔镜与开腹远端胃切除术（LDG）对胃癌患者术后手术部位感染（SSI）的差异。方法   制定严格的纳入标准与排除标准，收集LDG和开腹远端胃切除术（ODG）治疗胃癌的随机对照试验，按照Cochrane协助网推荐的方法对纳入研究进行系统分析。结果   6篇随机对照试验（767例患者）纳入分析，LDG组394例，ODG组373例。LDG组患者术后切口感染发生率[RR=0.32，95%CI（0.11，0.91），P =0.030]、总的手术部位感染发生率[RR=0.28，95%CI（0.12，0.70），P =0.006]较ODG组低，差异有统计学意义，但腹腔脓肿发生率[RR=0.35，95%CI（0.09，1.31），P =0.120]差异无统计学意义。结论   Meta分析显示，LDG患者术后SSI发生率明显低于ODG患者。

Abstract:

Objective To compare the differences of surgical site infection (SSI) between laparoscopic distal gastrectomy (LDG) and open distal gastrectomy (ODG) for gastric cancer. Methods We set up strict inclusion and exclusion criteria. All the randomized controlled trials (RCT) on LDG and ODG for gastric cancer were collected. Meta-analysis was performed according to the recommendation by the Cochrane handbook. Results Six RCTs including 767 patients were analyzed, who were divided into LDG group (n = 394) and ODG group (n = 373). Postoperative wound infection and SSI were significantly lower in LDG than in ODG [RR = 0.32, 95 % CI (0.11, 0.91), P = 0.03; RR = 0.28, 95 % CI (0.12, 0.70), P = 0.006]. There was no significant difference in intra-abdominal abscess between the two groups [RR = 0.35, 95 % CI (0.09, 1.31), P = 0.12]. Conclusions LDG was associated with a lower incidence of SSI, especially wound infection, as compared with ODG in the meta-analysis.