腹腔镜结直肠癌术后下肢深静脉血栓的Meta分析

Incidence of Postoperative Deep Venous Thrombosis after Open and Laparoscopic Colorectal Cancer Surgery:Meta-analysis

目的探讨腹腔镜与开腹结直肠癌手术后下肢深静脉血栓（deep venous thrombosis,DVT）发生率的差异。方法收集1989年1月～2010年5月已公开发表的腹腔镜与开腹结直肠癌手术后DVT发生情况的随机对照研究结果,按照Meta分析的要求对初步检索到的所有研究结果的质量进行评估和筛选,对入选的所有研究结果进行Meta分析,计算腹腔镜手术组相对开腹手术组术后发生DVT的优势比（odds ratio,OR）,评价腹腔镜手术和开腹手术后DVT发生率有无统计学差异。结果符合纳入标准的共9篇文章,总样本量2606例。其中腹腔镜手术组1453例,发生术后DVT11例;开腹手术组1153例,发生术后DVT15例。合并OR=0.63,95%可信区间为0.31~1.27。结论与开腹结直肠癌手术相比,腹腔镜手术不会增加术后DVT发生的风险。

Objective A higher incidence of deep venous thrombosis after laparoscopic or open colorectal cancer surgery is still debatable.A Meta-analysis was conducted to compare the incidence of postcolorectal surgery deep venous thrombosis between laparoscopic and open surgery groups. Methods Published randomized controlled trials were collected and evaluated;the data extracted were then analyzed by using meta-analysis.Odds ratio（OR） of the incidence of deep venous thrombosis between laparoscopic group and open surgery group were calculated to show the benefits of laparoscope or open surgery in terms of deep venous thrombosis occurred during hospital stay. Results A total of 2606 cases from 9 trials were included in our study.11 cases of deep venous thrombosis out of 1453 cases occurred in the laparoscopic group while 15 out of 1153 incidences of deep venous thrombosis occurred in the open surgery group.The pooled OR was 0.63（95% confidence interval 0.31 to 1.27）.Conclusion Laparoscopic surgery does not increase the risk of deep venous thrombosis.