快速康复外科联合肝切除术的安全性和有效性的Meta分析

Safety and efficacy of using fast-track surgery in hepatectomy:a Meta-analysis

目的:系统评价快速康复外科(FTS)联合肝切除手术的安全性和有效性。方法:检索多个国内外文献数据库,收集关于肝切除手术围手术期应用FTS的随机对照试验(RCT)或临床对照试验(CCT),截止日期为2014年10月,筛选符合入组标准的文献提取相关数据,并使用Rev Man 5.2.3软件进行Meta分析。结果:最终纳入5项RCT和11项CCT研究,共有1 529例患者,其中766例采用FTS治疗联合肝切除手术(FTS组),763例采用传统围手术期处理联合肝切除手术(对照组)。Meta分析结果显示,FTS组较对照组术后首次肛门排气时间、进食时间明显提前,住院时间明显缩短,住院费用明显减少,各项肝功能指标恢复时间明显缩短,术后总并发症发生率明显降低(均P<0.05)。结论:FTS联合肝切除手术安全有效,且利于患者术后恢复。

Objective： To systematically assess the safety and efficacy of using fast track surgery（FTS） technique in liver resection. Methods：The randomized controlled trials（RCTs） or clinical controlled trials（CCTs） concerning using fasttrack surgery in hepatectomy were collected by searching several national and international databases. Data collection ended in October 2014. After screening for inclusion and data extraction, Meta-analysis was performed by the Rev Man 5.2.3 sot ware. Results： Five RCTs and 11 CCTs were i nally included involving 1 529 patients, of whom 766 cases underwent hepatectomy with FTS protocol（FTS group） and 763 cases underwent hepatectomy with traditional perioperative management（control group）. Meta-analysis results showed that in FTS group compared with the control group,the time to first postoperative flatus and food intake, as well as length of hospital stay were signifi cantly shorter, hospitalization cost was significantly reduced, times for recovery of each of the liver function parameters and overall incidence of postoperative complications were all significantly decreased（all P0.05）. Conclusion： Application of FTS in hepatectomy is safe and effective, and it also can accelerate the postoperative recovery of patients.