国内腹腔镜结直肠癌切除术根治效果的Meta分析

Meta-analysis of the radical effect of laparoscopic resection for colorectal cancer in China

目的评价国内腹腔镜结直肠癌手术的肿瘤根治情况与远期预后。方法检索2007年10月前国内临床中心以中英文公开发表的结直肠癌腹腔镜与开腹手术根治效果和远期疗效的非随机对照研究（non-randomized comparative studies，NRCs）文献，提取相关指标后综合分析。结果14篇NRCs资料质量评分为18．92±1．27。腹腔镜与开腹治疗的患者基本特征均衡。结直肠癌腹腔镜手术的肠段切除长度较开腹手术短0．66cm，远端切缘距肿瘤距离较开腹手术远0．26cm，2年以上生存率是开腹手术的1．67倍。两种治疗方式的随访率、肿瘤直径大小、淋巴结清扫数目、肿瘤局部复发率和远处转移率差异无统计学意义。结论NRCs资料的Meta分析认为国内腹腔镜与开腹手术治疗结直肠癌的肿瘤根治情况无差别，但2年以上生存率具有一定优势。

Objective To evaluate the radical effect and prognosis of laparoscopic resection for coloreetal cancer in China. Methods Articles of non-randomized comparative studies （NRCs） of laparoscopic resection and open surgery for coloreetal cancer which were published before October 2007 were retrieved, and correlated indexes were extracted for meta-analysis. Results The mean quality score of the 14 articles selected was 18.92±1.27. The basic characteristics of patients in laparoscopie resection group were similar to those in open surgery group. Compared with open surgery group, the incised length of the intestine in the laparoscopic resection group was shorter by 0.66 cm, and the distance between distal margin of resection and tumor was farther by 0.26 cm. The 2-year survival rate of patients in laparoscopic group was 1.67 times higher than that of open surgery group. There was no significant difference upon follow-up rate, tumor diameter, number of resected lymph nodes, local recurrence rate and distal metastasis rate between the 2 groups. Conclusions The results of meta-analysis show that laparoscopic resection has the same radical effect as open surgery for colorectal cancer, but the 2-year survival rate of patients treated by laparoscopic resection is comparatively higher.