经自然腔道取标本手术与传统腹腔镜手术治疗结直肠癌疗效的Meta分析

Efficacy of natural orifice specimen extraction surgery and conventional laparoscopic surgery for colorectal cancer:a Meta-analysis

目的:通过Meta分析对比经自然腔道取标本手术(NOSES)与传统腹腔镜手术(LAP)治疗结直肠癌的临床疗效。方法:在PubMed、Cochrane Library、Embase、知网、中国生物医学文献数据库等检索关于NOSES与LAP治疗结直肠癌的随机对照实验相关文献,遵循筛选标准,并采用RevMan 5.4软件对纳入的文献数据进行Meta分析。结果:本研究共纳入12篇文献、1137例患者,其中NOSES组561例,LAP组576例。Meta分析结果显示,相较LAP组,NOSES组术中出血量少、术后下床活动早、术后排气早、术后住院时间短、术后疼痛轻、总并发症发生率低。两组手术时间、淋巴结清扫数量差异无统计学意义。结论:与LAP相比,NOSES治疗结直肠癌具有更好的近期疗效与安全性。

Objective:To compare the curative effect of natural orifice specimen extraction surgery(NOSES) and traditional laparoscopic(LAP) treatment of colorectal cancer by Meta-analysis.Methods:Following the screening criteria,randomized controlled trial papers on NOSES and LAP surgery in the treatment of colorectal cancer were searched in databases,including PubMed,Cochrane Library,Embase,CNKI and SinoMed.RevMan 5.4 was used for Meta-analysis.Results:A total of 12 papers including 1 137 cases were selected,including 561 cases in the NOSES group and 576 cases in the LAP group.Meta-analysis results showed,compared with the LAP group,the NOSES group had less intraoperative blood loss,earlier postoperative ambulation time,earlier postoperative exhaust time,shorter postoperative hospital stay,less postoperative pain,and fewer total complications.No significant difference was found between the two groups with respect to operation time or lymph nodes harvested.Conclusions:NOSES is more effective and safer in the short-term treatment of colorectal cancer than LAP surgery.