单孔腹腔镜技术在腹股沟疝修补术中临床应用价值的Meta分析

Meta-analysis of application value of single-incision laparoscopic technique in inguinal hernia repair

目的:探讨单孔腹腔镜技术应用于腹股沟疝修补术中的有效性和安全性。方法:计算机检索国内外文献数据库,收集比较单孔腹腔镜疝修补术与多孔腹腔镜疝修补术的临床研究,采用STATA 12.0进行Meta分析。结果:共纳入17项研究,其中随机对照试验5项,回顾性研究12项,涉及患者1722例。Meta分析结果显示,单孔腹腔镜疝修补术在术后恢复时间(SMD=-0.35,95%CI=-0.56^-0.15,P=0.001)及术后第7日疼痛评分(SMD=-0.27,95%CI=-0.53^-0.01,P=0.044)方面优于多孔腹腔镜疝修补术,而两者在手术时间(SMD=0.03,95%CI=-0.20~0.26,P=0.811)、术后住院时间(SMD=-0.07,95%CI=-0.23~0.09,P=0.393)、术后第1日疼痛评分(SMD=-0.19,95%CI=-0.45~0.07,P=0.153)、术后并发症发生率(OR=0.98,95%CI=0.69~1.38,P=0.896)、术后疝复发率(OR=1.07,95%CI=0.46~2.48,P=0.872)方面均无统计学差异。结论:与多孔腹腔镜疝修补术比较,单孔腹腔镜疝修补术能有效的减少患者术后恢复时间与术后疼痛,并能带来良好的美容效果,且具有相似的安全性和有效性。

Objective： To evaluate the safety and efficacy of using single incision laparoscopic technique in inguinal hernia repair. Methods： The clinical studies comparing single- and multi-incision inguinal hernia repair were collected by searching several national and international databases. Meta-analysis was performed by using STATA 12.0 software.Results： Seventeen studies were finally enrolled, including S randomized controlled trials and 12 retrospective studies, and involving 1 722 patients. The results of Meta-analyses showed that single-incision inguinal hernia repair was superior to multbincision inguinal hernia repair in respects of postoperative recovery time （SMD=-0.35, 95% CI=-0.56--0.15, P=0.001） and pain score on postoperative day 7 （SMD=-0.27, 95% CI=-0.53-0.01, P=0.044）, while there was no significant difference between the two procedures in terms of operative time （SMD=0.03, 95% CI=-0.20-0.26, P=0.811）, length of postoperative hospital stay （SMD=-O.07, 95% CI=-0.23- 0.09, P=0.393）, pain score on first postoperative day （SMD=-0.19, 95% CI=-0.45-0.07, P=0.153）, and incidence of postoperative complications （0R=0.98, 95% CI=0.69-1.38, P=0.896） and recurrence of hernia （OR=1.07, 95% CI=0.46-2.48, P=0.872）. Conclusion： Compared with multi-incision inguinal hernia repair, single-incision inguinal hernia repair can effectively reduce postoperative recovery time and pain of the patients, and provide favorable cosmetic results, and has similar safety and efficacy.