论文部分内容阅读
目的:对比腹腔镜直肠癌手术和传统开腹手术的临床效果。方法:检索近20年来发表的关于比较腹腔镜与传统开腹手术治疗直肠癌临床效果的随机对照试验。按纳入标准筛选文献,用Review Manager 5.1软件行Meta分析。结果:最终纳入14个随机对照试验,共2 114例患者,其中腹腔镜组1 111例,开腹组1 003例。腔镜组与传统开腹组比较,术中出血量少、胃肠功能恢复时间及下床活动时间早、住院时间缩短、伤口感染减少,差异均有统计学意义(均P<0.05);手术并发症发生率包括输尿管损伤、尿潴留、肠梗阻、吻合口瘘,切口疝,两组组间差异均无统计学意义(均P>0.05);两组在淋巴结清扫数量、标本长度、环周切缘阳性率、局部复发、切口或穿刺口种植转移、远处转移、3,5年总体生存率、3,5年无病生存率等指标上均无统计学差异(均P>0.05)。结论:腹腔镜直肠癌手术术中出血少、术后恢复快、住院时间短,肿瘤根治效果与传统开腹手术相仿,可作为治疗直肠癌的标准术式。
Objective: To compare the clinical effects of laparoscopic surgery and traditional laparotomy. METHODS: A randomized controlled trial comparing the clinical effects of laparoscopic versus traditional laparotomy in the treatment of rectal cancer was searched in the last 20 years. The literature was screened by inclusion criteria and Meta-analysis was performed using Review Manager 5.1 software. Results: A total of 1414 randomized controlled trials were included, of which 1,111 were laparoscopic and 1 003 were laparotomy. Compared with the traditional laparotomy group, laparoscopic group had less intraoperative blood loss, gastrointestinal function recovery time, early bed ambulation time, shorter hospital stay, and lower wound infection, with significant differences (all P <0.05) Incidence of complications including ureteral injury, urinary retention, intestinal obstruction, anastomotic fistula, incisional hernia, there was no significant difference between the two groups (all P> 0.05); two groups in the number of lymph node dissection, specimen length, No significant difference was found in the positive rate of margins, local recurrence, implantation and incision or incision implantation, distant metastasis, overall survival at 3 and 5 years, and disease-free survival at 3 and 5 years (all P> 0.05). Conclusions: Laparoscopic rectal cancer surgery less bleeding, fast recovery, shorter hospital stay, tumor resection effect and traditional laparotomy similar to the standard surgical treatment of rectal cancer.