国内直肠癌患者腹腔镜手术和传统开腹手术疗效指标的meta分析

Comparison of outcomes of laparoscopic with open surgery in rectal cancer： A meta-analysis

目的评价腹腔镜手术（LR）和传统开腹手术（OR）治疗直肠癌的疗效。方法采用计算机检索中国知网（CNKI）、Wanfang、维普资讯中文期刊服务平台（VIP）、Pubmed及webofScience等中英文数据库，收集有关直肠癌2种治疗方式的疗效的文献。根据异质性检验结果采用随机效应模型或固定效应模型对提取数据进行合并分析。结果最终纳入14篇文献，共2314例患者，其中LR组1026例，0R组1288例。与0R组比较，LR组患者手术中出血量减少、肠功能恢复时间减少、手术时间延长、术后并发症发生率降低，差异均有统计学意义[加权均数差（WMD）=-74．503、-1．464、14．891、优势比（OR）-0．608，95％可信区间（95％CD：-88．078～-60．929、-2．092～-0．836、6．304～23．479、0．448～0．825，P=0．001l，淋巴结检出数目减少，但差异无统计学意义（WMD=-0．096，95％CI：-0．629～0．437，P=0．725）。结论LR治疗直肠癌疗效优于0R。

Objective To evaluate the outcomes of laparoscopic（LR） and open surgery（OR） for rectal cancer. Methods Articles related with outcomes of LR and OR were searched using CNKI,Wanfang Data, VIP, Pubmed and Web of Science. Random or fixed effect model was chosen to pool the original data according to the results of heterogeneity. Results Fourteen publications were in- cluded with total sample of 2 314 with 1026 for LR and 1 288 for OR. Analysis showed that LR had less blood loss（WMD=-74. 503,95%CI：-88. 078,--60. 929,P=0. 001）,less harvested lymph nodes（WMD=-0. 096,95% CI：-0. 629,0. 437,P=0. 725） and less recovery time（WMD= -1. 464,95 % CI：-2. 092,-0. 836, P〈0. 001）as compared to OR. LR had longer operative time （WMD= 14.891,95% CI： 6. 304,23. 479, P = 0.001 ）and was superior to OR in postoperative complications （OR = 0. 608,95 % CI： 0. 448,0. 825 ,P=0. 001）. Conclusion Clinical outcomes after laparoscopic surgery were favorable compared to open surgery.