同时性结直肠癌肝转移同期与分期手术疗效的Meta分析

Comparison between simultaneous resection and staged resection for synchronous colorectal liver metastasis:a Meta-analysis

目的对比分析同时性结直肠癌肝转移行同期手术与分期手术切除转移灶的疗效。方法通过计算机文献检索ISI Web of Knowledge、Pubmed及中国期刊网,检索国内外自1990年1月至2010年12月间公开发表的有关结直肠癌肝转移治疗的文章。通过Meta分析对比同时性结直肠癌肝转移同期、分期术后围手术期并发症、死亡率、5年生存率。结果同时性结直肠癌肝转移同期手术切除组与分期手术切除组比较,同期手术组围手术期并发症发生率36.4%与分期手术组35.6%(P=0.957)相似,在围手术期死亡率(OR=1.91,95%CI:0.90～4.08,P=0.09)及5年生存率(OR=1.08,CI:0.73～1.61,P=0.69)方面无统计学差异。结论与分期切除相比,同时性结直肠癌肝转移行同期切除同样安全、有效。

Objective To compare the therapeutic effect of simultaneous resection and staged resection for synchronous colorectal liver metastasis.Methods PubMed,ISI Web of Knowledge and the Net of Chinese Journals were retrieved for articles published at home and abroad between January 1990 and December 2010 on colorectal liver metastasis.Meta-analysis was made to compare the peri-operative complications,mortality rate and five-year survival rate after simultaneous and staged resections for synchronous colorectal liver metastasis.Results Complication rates were similar in both groups: 196 of 538 patients(36.4%) in the simultaneous resection group vs.400 of 1124 patients(35.6%) in the staged resection group(P=0.957).No significant differences were found between the two groups in mortality rate(OR=1.91,95% CI: 0.90-4.08,P=0.09) and 5-year survival rate(OR=1.08,CI: 0.73-1.61,P=0.69).Conclusion Simultaneous resection is as safe and efficient as staged resection in treating patients with synchronous colorectal liver metastasis.