结直肠癌同时性肝转移行一期和二期肝切除术安全性的荟萃分析

A meta-analysis of the safety of simultaneous versus staged resection for synchronous liver metastasis from colorectal cancer

目的 评估结直肠癌同时性肝转移患者一期和二期肝切除术的安全性.方法 通过检索PubMed/Medline,ISI Web of Knowledge,Springer link,Ebscohost,Elsevier Wiley Interscience和Google Scholar,搜集1989年1月至2009年3月关于结直肠癌同时性肝转移患者行一期和二期肝切除术的对照研究,对一期和二期手术组患者的手术并发症发生率和围手术期死亡率进行荟萃分析.结果 检索到7篇文献共计1390例结直肠癌同时性肝转移行肝切除术的患者,其中一期手术者495例,二期手术者895例.一期手术者围手术期死亡率（2.4%）高于二期手术者（1.1%）,差异有统计学意义（Peto OR 3.39,95% CI 1.29～8.93,P=0.01）;两组手术并发症发生率分别为33.9%和29.8%,两组比较差异无统计学意义[OR（随机）0.88,95% CI 0.51～1.51,P=0.64].结论 同时性结直肠癌肝转移患者有选择地行二期手术是合理和安全的.

Objective To evaluate the safety of simultaneous and staged resection for synchronous liver metastasis from colorectal cancer. Methods PubMed/Medline,ISI Web of Knowledge,Springer link,ebscohost,Elsevier Wiley Interscience,Google Scholar were searched for case-control studies concerning simultaneous versus staged resection of synchronous liver metastasis from colorectal cancer between January 1989 and March 2009.A meta-analysis sas performed to analyze the morbidity and periopemtive mortality. Results Seven case-control studies,with a total of 1 390 patients of liver metastasis from colorectal cancer undergone curative hepatic resection,were reviewed.There were 495 simultaneous and 895 staged resections.Periopemtive mortality was 1.1% in the staged resection group and 2.4% in the the simultaneous group,the difference was statistically significant[Peto OR 3.39,95% CI 1.29-8.93,P=0.01].No significant difference was found in morbidity between two groups [OR （random） 0.88,95% CI 0.51-1.51,P=0.64]. Conclusion Selective staged resection is safe for synchronous liver metastasis from colorectal cancer.