腹腔镜直肠癌前切除术后复发和生存的荟萃分析

Five-year recurrence and survival rate of rectal cancer patients after laparoscopic anterior resection:a meta-analysis

目的:评价腹腔镜直肠癌前切除术(LAR)的根治性。方法:在Pubmed、Cochrane library和Elsevier等数据库中检索2010至1990年发表的有关LAR的文献,由2名独立的研究人员进行文献筛选和数据提取,采用RevMan 4.2软件进行荟萃分析。结果:有2项随机对照研究和4项非随机对照研究共1 602例病人符合入选标准。LAR组术后5年复发率与开腹直肠癌前切除术(OAR)组无统计学差异(OR=0.78,P=0.23);LAR组术后5年总生存率高于OAR组(78.1%比66.5%,OR=1.59,P=0.0003),术后5年无病生存率两组无统计学差异(82.2%比76.9%,OR=1.33,P=0.10)。结论:LAR术后5年的生存率不低于开腹手术,复发率不高于开腹手术。

Objective To assess the five-year survival and recurrence rate of rectal cancer patients after laparoscopic anterior resection（LAR） versus open anterior resection（OAR）.Methods All studies in English or Chinese on LAR and rectal cancer published between 2010 and 1990 were identified through searches of Pubmed,Cochrane library,Elsevier,and so on.Two independent assessors reviewed the studies using a critical criteria.Where raw data were extracted,meta-analysis was performed using the RevMan 4.2 software.Results Two randomised controlled trials and four non-randomized controlled studies on 1 602 patients qualified for the meta-analysis according to our criteria.The difference of 5-year recurrence between LAR group and OAR group was not significant（OR=0.78,P=0.23）,and The difference of 5-year disease-free survival between LAR and OAR group was not significant（82.2% vs.76.9%,OR=1.33,P=0.10） either.However,The difference of 5-year overall survival between LAR and OAR group was significant（78.1% vs.66.5%,OR=1.59,P=0.0003）.Conclusions The 5-year recurrence of LAR patients was not more than OAR patients,and 5-year survival was not less than OAR patients.