摘要
目的探讨腹腔镜经腹膜前修补术(transabdominal preperitoneal prosthetic,TAPP)或腹腔镜完全腹膜外修补术(total extraperitoneal prosthetic,TEP)对比开放Lichtenstein术治疗腹股沟疝在临床疗效方面有无差异。方法计算机检索CENTRAL(the Cochrane central register of controlledtrials)、Medline、EMBASE、万方、中国生物医学文献数据库系统(CBM)、中国期刊全文数据库(CNKI)等,搜集国内外公开发表的TAPP或TEP对比开放Lichtenstein术治疗腹股沟疝的临床随机对照研究。应用统计软件Stata11.0和Review Manager 5.0进行数据分析,并根据Cochran手册文献质量评价标准对入选文献进行质量评价。结果最终纳入分析的文章有16篇,腹腔镜组1361例(TAPP组1044例,TEP组317例),Lichtenstein组1261例,Meta分析的结果显示接受腹腔镜(TAPP/TEP)治疗的患者与接受Lichtenstein患者相比:手术时间明显延长(MD=7.58,95%CI=2.94～19.51,P<0.001);两组患者术后并发症发生率无差异(RR=0.97,95%CI=0.84-1.11,P=0.652);腹腔镜组医疗费用明显高于Lichtenstein组。结论与传统的Lichtenstein术相比,腹腔镜治疗腹股沟疝在临床疗效及成本效益方面并无优势,对于腹股沟疝患者,常规推荐Lichtenstein术治疗。
Objective To explore the clinical effect between laparoscopy and Lichtenstein in repairing of adult inguinal hernia. Methods Computer searching CENTRAL （ the Cochrane central register of controlledtrials ）, Medline, EMBSE, CBM, CNKI and WANFANG et al, we collected published randomized controled trials about the laparoscopy compare with Lichtenstein in repairing of adult inguinal hernia. The data was analysised by using statistic software Statal 1.0.The methodological quality was assessed by using Cochrane Handbook. Results All 16 trials were analyzed in the meta analysis.1361 patients were in the laparoscopy group and 1261 patients were in the Lichtenstein group. A significant longer operation time was observed in the laparoscopy group compare with the Lichtenstein （ MD=7.58,95% CI=2.94-19.51, P 〈 0.01 ） ; The overall perioperative complication rate was relatively equal between the two groups （RR=0.97,95%CI=0.84-1.11, P=0.652 ）; But the medical cost was much higher in the laparoscopy group compared with Lichtenstein. Conclusion Compared with traditional Lichtenstein, laparoscopic surgery has no advantage in clinical efficacy and cost- effectiveness in treating inguinal hernia. So the conventional Lichtenstein surgery is recommended for patients with inguinal hernia.
出处
《中国现代医生》
2011年第25期4-6,共3页
China Modern Doctor
