后腹腔镜与开放手术治疗嗜铬细胞瘤安全性及有效性的Meta分析

Retroperitoneoscopic and open surgery in the treatment of pheochromocytoma safety and efficacy: Meta analysis

目的评价后腹腔镜手术与开放手术治疗嗜铬细胞瘤的安全性及有效性。方法检索国内外后腹腔镜与开放手术治疗肾上嗜铬细胞瘤的回顾性研究,截止时间为2016年2月,由2名研究者独立对文献质量评价后采用Review Manager 5.1.0软件进行Meta分析。结果共纳入13篇符合要求的文献计616例病人。Meta分析结果显示:(1)有效性方面:与开放组相比,腹腔镜组的手术时间及术后住院时间短,肿瘤直径较小。(2)安全性方面:与开放组相比,腹腔镜组的术中出血量少,术后胃肠功能恢复时间、术后下床活动时间及引流时间短,术中输血例数、术中血压升高例数及引流量少,并发症发生率低。结论后腹腔镜和开放手术均能有效治疗嗜铬细胞瘤,与开放手术相比,后腹腔镜具有手术时间短、标准化、安全性高、并发症发生率相对较低等优点。但后腹腔镜治疗嗜铬细胞瘤的效果及安全性尚需多中心、高质量大样本的随机对照试验进一步验证。

Objective To evaluate retroperitonescopic and open surgery in the treatment of pheochromocytoma efficacy and safety.Methods We retrieved the retrospective studys on retroperitonescopic and open surgery for pheochromocytoma at home and abroad.Deadline for February 2016,relevant data was selected by two reviewers after quality evaluation of the included trials,and the statistical software Rev Man 5. 1. 0 was used for Meta analysis. Results Totally 13 conform to the standard of the literature with 616 cases were included in this study. Meta analysis showed:(1) effectiveness: compared with open surgery,retroperitonescopic showed a shorter operation time and postoperative hospital stay,smaller Tumor diameter.(2) safety: compared with open surgery,retroperitonescopic showed a less intraoperative blood loss; shorter postoperative gastrointestinal function recovery time,postoperative bed activity time,and drainage time; less intraoperative blood transfusion cases,intraoperative blood pressure increases the number of cases,and volume of drainage;lower complication rate. Conclusions Retroperitonescopic is an effective method in the treatment of pheochromocytoma. Compared with open surgery,retroperitonescopic operation has some advantages,such as time short,standardization,high safety,low complication rates and so on. However,the efficacy and safety of laparoscopic treatment of pheochromocytoma still needs to be the multi-center and high quality of large sample randomized controlled trial to further verification.