系统评价与Meta分析经脐单孔与三孔腔镜阑尾切除术的安全可行性

Transumbilical single site versus conventional three-port appendicectomy with a systematic review and Meta analysis

目的 通过与经典三孔腔镜阑尾切除术（CLA）比较,系统评价与Meta分析经脐单孔腔镜阑尾切除术（SSLA）的安全可行性.方法 从PubMed、Embase、Cochrane Library等电子数据库中检索2000年1月1日-2012年12月31日发表的文献,筛选出具有SSLA与CLA对照的、研究对象为成年人的腔镜阑尾切除术英文文献,运用Stata软件进行Meta分析.结果 共有11篇文献,2008年3月-2011年10月接受手术的998例患者纳入本研究,其中SSLA组435例,CLA组563例.SSLA组患者与CLA组患者比较,两组的手术时间（z=1.48,P=0.140）、术后24 h内疼痛评分（z=0.83,P=0.409）、术后进食时间（z=0.38,P=0.707）、并发症发病率（z=0.46,P =0.647）及患者住院时间（z=0.36,P=0.722）差异均无统计学意义.结论 SSLA的手术时间、术后疼痛、术后恢复饮食时间、术后并发症、住院时间与CLA没有差异.

Objective This study aimed at evaluating the safety and feasibility of transumbilical single site laparoscopic appendectomy （SSLA） by systematic review and Meta analysis of literature comparing with conventional tree-port laparoscopic appendectomy （CLA）.Methods The articles published from January 2000 to December 2012 were searched from electronic databases of PubMed,Embase,and the Cochrane Library.The literature with comparative studies of SSLA with CLA for adult patients was selected.And,the systematic review and Meta analysis carried out using Stata software.Results Eleven articles with 998 cases receiving operation during March 2008 to October 2011 were enrolled into study.There were 435 cases with SSLA and 563 cases with CLA.Compared the cases with SSLA and cases with CLA,there was no difference significantly in operative time （z =1.48,P =0.140）,pain score in the 24 hours after surgery （z =0.83,P =0.409）,diet start（z =0.38,P =0.707）,postoperative complications （z =0.46,P =0.647）,hospital stay （z =0.36,P =0.722）.Conclusions SSLA are not different in operative time,postoperative pain,diet start,postoperative complications,hospital time comparing with that in CLA.