3D腹腔镜在胃癌手术中的应用效果及安全性的Meta分析
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孙莉, Email: sunli75@163.com

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中华医学会2016年医学教育研究立项课题资助项目(2016B-HL031)。


Efficacy and safety of using 3D laparoscopic technique in gastric cancer surgery: a Meta-analysis
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    摘要:

    目的:评价3D腹腔镜技术在胃癌手术中的应用效果及安全性。 方法:检索多个国内外文献数据库,收集3D腹腔镜应用于胃癌手术的临床对照研究。由2名独立研究者根据纳入与排除标准对文献进行筛选、提取资料和评价质量后,采用RevMan 5.2软件进行Meta分析。 结果:最终纳入7项研究,共有650例患者。Meta分析结果显示,与对照组(2D腹腔镜手术)比较,3D腹腔镜手术的手术持续时间缩短(MD=-0.59,95%CI=-0.76~-0.42,P<0.000 01),术中出血量减少(MD=-0.56,95%CI=-0.73~-0.39,P<0.000 01),住院费用增加(MD=378.42,95%CI=171.81~585.04,P=0.000 3)。所纳入的研究显示,3D腹腔镜手术在其他疗效指标及安全性方面与对照组无统计学差异(均P>0.05)。 结论:3D腹腔镜辅助胃癌手术在手术时间与术中出血量方面具有优势,手术安全性较好,但手术费用偏高。

    Abstract:

    Objective: To evaluate the efficacy and safety of using 3D laparoscopic technique in gastric carcinoma surgery. Methods: The randomized clinical trials regarding using 3D laparoscopic technique in gastric carcinoma surgery were collected by searching several national and international online databases. Article screening, data extraction and quality assessment were performed by two independent reviewers according to the defined inclusion and exclusion criteria, and then, Meta-analysis was performed by using RevMan 5.2 software. Results: Seven studies were finally included with 650 patients. Results of Meta-analysis showed that the operative time was shortened (MD=–0.59, 95% CI=–0.76––0.42, P<0.000 01), and intraoperative blood loss was reduced (MD=–0.56, 95% CI=–0.73--0.39, P<0.000 01), while hospitalization expense was increased (MD=378.42, 95% CI=171.81–585.04, P=0.000 3) in 3D laparoscopic surgery compared with control group (2D laparoscopic surgery). Results of the included studies indicated that other efficacy parameters and safety of 3D laparoscopic surgery had no significant difference compared with control group (all P>0.05). Conclusion: 3D laparoscopic assisted surgery for gastric carcinoma has advantage in terms of operative duration and blood loss, and it also has better surgical safety, but the hospitalization cost may increase.

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张春燕|孙莉.3D腹腔镜在胃癌手术中的应用效果及安全性的Meta分析[J].中国普通外科杂志,2016,25(10):1381-1387.
DOI:10.3978/j. issn.1005-6947.2016.10.003

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  • 收稿日期:2016-06-30
  • 最后修改日期:2016-09-13
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  • 在线发布日期: 2016-10-15