单切口Mini-Arc吊带术与TVT-O治疗女性压力性尿失禁疗效比较的Meta分析

Single-incision Mini-Arc versus TVT-O for female stress urinary incontinence:a meta-analysis of effectiveness and complications

目的：系统评价单切口Mini-Arc吊带术与经闭孔无张力尿道中段悬吊术（TVT-O）治疗女性压力性尿失禁（SUI）的术后临床疗效。方法：通过万方数据库、维普、Pubmed、Medline等数据库进行文献检索,将比较单切口Mini-Arc吊带术与TVT-O的随机对照研究纳入本研究,检索时间段为1996年1月-2014年9月,从符合要求的文献中收集数据资料,应用RevMan 5.2软件进行Meta分析。结果：纳入本研究的6个随机对照研究共计580例患者,Meta分析发现,单切口Mini-Arc吊带术在术后腹股沟区疼痛情况方面优于TVT-O（P〈0.05）,而在术后12个月客观治愈率、手术时间、主观治愈率、术后疼痛程度、术后排尿困难率、术后病情恶化率、二次手术发生率等方面差异无统计学意义（P〉0.05）。结论：单切口Mini-Arc吊带术较TVT-O治疗女性SUI在术后腹股沟区疼痛情况方面的疗效较好,但在更多远期疗效方面的最终判断有待于更多的循证证据。

Objective： To assess single-incision Mini-Arc versus tension-free vaginal tape-obturator （TVT-O） for female stress urinary incontinence （SUI）. Method： The databases such as WanFang Data, VIP, Pubmed and Medline were searched to collect the randomized control trials （RCTs） about the clinical effectiveness of single-incision Mini-Arc versus TVT-O for female SUI. The retrieval time was from January 1996 to September 2014. A meta-analysis of acquired data was performed through RevMan 5.2 software. Result： A total of six RCTs involving 580 patients were included. The meta-analysis showed that there were no statistical differences in degrees of postoperative pain, patient-reported cure rate, operative time, postoperative voiding difficulties, de novo urgency and repeat continence surgery between two groups. For postoperative groin pain single-incision Mini-Arc slings was superior to TVT-O. Conclusion： For patients undergoing single-incision Mini-Arc slings less groin pain is observed than in group TVT-O （P〈0.05）. For quantity limitation arid low methodological quality of included stud- ies, this conclusion still needs to be further proved by performing more high-quality studies.