腹腔镜远端胃癌根治术腹腔内与腹腔外胃 十二指肠吻合术早期疗效比较的meta分析

Meta-analysis of early outcomes of intracorporeal and extracorporeal gastroduodenostomy after laparoscopic distal gastrectomy for gastric cance

摘要:

目的 比较完全性腹腔镜远端胃癌根治术（TLDG）与腹腔镜辅助下远端胃癌根治术（LADG）治疗胃癌效果的比较。方法 对2008年-2013年通过PubMed、EMBASE、Medline、中国期刊全文数据库、万方数据等有关TLDG与LADG的回顾性分析文献进行定量综合分析，采用ReMan 5.1软件用固定效应模型进行Meta分析。结果 按入选纳入标准，共6篇文献纳入研究，meta分析结果显示：TLDG术中出血量较LADG少31.26 mL（P =0.005）；TLDG组术后止痛剂平均使用次数较LADG组少0.38次（P =0.04）；TLDG术后1 d血清C反应蛋白水平降低0.93 mg/mL（P =0.03），手术时间、住院时间、首次排气时间及术后并发症组数据均无统计学意义（P >0.05）。结论 根据数据分析无法证明TLDG优于LADG，方法的选择可根据患者具体情况及外科医生偏好来选择。

Abstract:

【Objective】 To compare the effect difference of totally laparoscopic distal gastrectomy (TLDG) and laparoscopic-assisted distal gastrectomy (LADG). 【Methods】 Randomized controlled trial reports on TLDG and LADG from 2008 to 2013 were collected fromPubMed,EMBASE,Medline, China National Knowledge Infrastructure (CNKI), Wanfang Databases and Pubmed. RevMan 5.1 software were used for data analysis. 【Results】 According to the included criteria, 6 clinical trials were selected finally. Meta-analysis showed that: TLDG blood loss was less than LADG 31.26 mL (P =0.005); The frequency of analgesic usage in the TLDG group was lower 0.38 times than LADG group (P =0.04); TLDG group after one day of serum C-reactive protein levels decreased 0.93 mg/mL (P=0.03), there was no statistical difference in rate of conversion to operative time, hospital stay, and postoperative complications between the two groups (P ＞0.05). 【Conclusion】 We could not demonstrate the clinical superiority of TLDG over LADG based on our data and a rapid systematic review and meta-analysis. The surgical method may be selected according to patient conditions and the surgeon's preference.