腹腔镜与开腹胃癌根治术后肠梗阻发生率比较Meta分析

Comparison of the incidence of postoperative ileus following laparoscopic and open radical resection for gastric cancer:A Meta analysis

目的比较腹腔镜与开腹手术治疗胃癌术后肠梗阻的发生率。方法通过Pub Med、EMBASE、OVID、Medline、中国期刊全文数据库、万方数据发表的有关腹腔镜与传统开腹胃癌根治术后发生肠梗阻相关随机对照研究文献进行定量分析,检索时间从建库至2014年3月止,采用Re Man 5.1软件对数据进行Meta分析。结果按入选纳入标准,共14篇文献纳入研究,总样本量3997例,其中腹腔镜组2196例,术后发生肠梗阻18例,开腹组1801例,术后发生肠梗阻46例,合并RR=0.37,95%CI：0.23~0.62,提示腹腔镜组术后肠梗阻的发生率为开腹组的37%,差异有统计学意义（P〈0.01）。结论相对于开腹胃癌手术,腹腔镜胃癌手术可以降低术后早期肠梗阻的发生率。

Objective To compare the incidence of postoperative ileus following laparoscopic and open radicalresection for gastric cancer.Methods Randomized controlled trial reports published from built this database to March2014 were searched in the Pub Med、EMBASE、OVID、Medline、China National Knowledge Infrastructure（CNKI） andWanfang databases.Articles were identified which compared the occurrence rate of postoperative iles betweenlaparoscopic resection and conventional open resection for gastric cancer.Data were analyzed by Rev Man5.1 software.Results Fourteen studies including 3997 cases were analyzed. A total of 2196 cases received laparoscopic surgery,ofwhom 18 developed postoperative ileus. There were 1801 cases underwent open surgery,of whom 46 developed earlypostoperative ileus. The pooled relative risk was 0.37 with a 95% confidence interval of 0.23-0.62. The difference wassignificant statistically（P〈0.01）.Conclusion Compared with open surgery,laparoscopic gastric cancer resection canreduce the incidence of postoperative early ileus.