本文已被：浏览 599次 下载 445次
投稿时间：2021-07-15 网络发布日期：2022-03-20
投稿时间：2021-07-15 网络发布日期：2022-03-20
中文摘要: 目的 通过Meta分析评估腹腔镜右半结肠癌根治术中尾侧与中间入路的临床疗效。 方法 对中国知网、万方数据库、PubMed、Embase、Cochrane图书馆等数据库进行全面的文献检索，搜集国内外比较两种不同手术方法在腹腔镜右半结肠癌根治术中临床疗效的文献。 结果 共纳入12篇文献，总计1 043例患者，其中尾侧入路组522例，中间入路组521例。结果表明，与中间入路法比较，尾侧入路法手术时间短（WMD＞=-26.14,95%CI＞：-34.38～-17.90,P＜0.01），术中出血量少（WMD＞=-13.42,95%CI＞:-17.35～-9.50,P＜0.01），中转开腹率(OR＞=0.17,95%CI＞：0.08～0.36,P＜0.01）及术后并发症率低（OR＞=0.49,95%CI＞：0.35～0.68,P＜0.01)。两组淋巴结清扫数目及肛门排气时间比较，差异无统计学意义（P＞0.05）。 结论 采用尾侧入路实施腹腔镜右半结肠癌根治术安全可行，具有较好的近期疗效，相较于中间入路具有手术时间短、术中出血量少、中转开腹率及并发症率低的优点。
Abstract:Objective To evaluate the clinical efficacy of caudal approaches (CA) and intermediate approaches (IA) in laparoscopic radical resection of right colon cancer by Meta-analysis. Methods A comprehensive literature search was conducted by using CNKI, Wanfang Data, PubMed, Embase and Cochrane Library to collect the literatures on the clinical efficacy of two different surgical approaches in laparoscopic radical resection of right colon cancer at home and abroad. Results A total of 1043 patients were enrolled in 12 literatures, including 522 cases in CA group and 521 cases in IA group. The analysis results showed that the operation time (WMD＞=-26.14,95%CI＞:-34.38--17.90), operative blood loss (WMD＞=-13.42,95%CI＞:-17.35--9.50), rate of conversion to laparotomy (OR＞=0.17,95%CI＞:0.08-0.36) and postoperative complication rate (OR＞=0.49,95%CI＞:0.35-0.68) in CA group significantly decreased compared with those in IA group (P<0.01). There was no significant difference in the number of lymph nodes resection and post-operative anal exhaust time between two groups(P>0.05). Conclusion For laparoscopic radical resection of right colon cancer, CA is safe and feasible with good short-term curative effect. Compared with the IA, it has the advantages of shorter operation time, less intraoperative bleeding and lower rates of conversion to laparotomy and lower rate of post-operative complication.
keywords: Radical resection of right colon cancer Laparoscopy Caudal approach Intermediate approach Meta analysis
文章编号： 中图分类号：R735.3+5 文献标志码：A
基金项目:河南省科技厅重点攻关项目（122102310239）
| Author Name | Affiliation |
| XU Shun， NIU Yue-ping， DONG Feng, LI Ze-shan, HAN Bin | The Second Clinical College of Zhengzhou University， Zhengzhou, Henan 450014， China |
引用文本：
徐顺,牛跃平,董峰,等.尾侧与中间入路在腹腔镜右半结肠癌根治术中比较的Meta分析[J].中国临床研究,2022,35(3):307-312，318.
徐顺,牛跃平,董峰,等.尾侧与中间入路在腹腔镜右半结肠癌根治术中比较的Meta分析[J].中国临床研究,2022,35(3):307-312，318.