保留肌肉小切口手术与胸腔镜治疗非小细胞肺癌近期疗效比较研究的临床荟萃分析

Clinical meta-analysis of recent study on the effect of small incision and thoracoscopic treatment of non-small cell lung cancer

目的通过临床荟萃分析比较保留肌肉小切口手术与胸腔镜手术治疗非小细胞肺癌的近期疗效。方法通过对中国期刊全文数据库CNKI、维普、万方及Pub Med数据库进行检索,期限为2005年11月至2016年11月,收集保留肌肉小切口手术与胸腔镜手术治疗非小细胞肺癌比较研究的文献,依据Jadad评分标准评价纳入文献的质量,采用Review Manager 5.0软件进行Meta分析。结果共纳入8篇文献,包括研究组363例,对照组357例。两组术中淋巴结清扫数比较差异无显著性(森林图合并效应量WMD=-0.28,Z=0.91,P=0.36,95%CI为-0.88^-0.32);全胸腔镜治疗的住院时间明显短于保留肌肉小切口手术治疗(森林图合并效应量WMD=-4.30,Z=7.37,P<0.00001,95%CI为-5.45^-3.16),且不良反应明显少于保留肌肉小切口手术治疗(森林图合并效应量OR=0.25,Z=5.63,P<0.00001,95%CI为0.15~0.40)。结论与保留肌肉小切口手术相比,胸腔镜治疗非小细胞肺癌术中淋巴结清扫数量相似,但术后恢复方面有明显优势,且安全性高。

Objective To compare the the clinical effect of small muscle incision and thoracoscopy in the treatment of non-small cell lung cancer from meta-analysis.Method CNKI,Vipu,Wanfang,pubmed and other databases were searched for ＂Thoracoscopy＂,＂non-small cell lung cancer＂ as the main keywords from November 2005 to November 2016.Frames,design literature inclusion and exclusion criteria,collection of literatures on the retention of small incision and thoracoscopy in the treatment of non-small cell lung cancer were reported.The quality of the included literature was evaluated according to the Jadad scoring criteria and Meta-analysis was performed using Review Manager 5.0 software.Result In this study,8 literatures were included in this study.A total of 8 articles were included,including 363 cases in the study group and 357 cases in the control group.Comparison of lymph nodes in the two groups was no significant difference（Figure forest combined effect of the amount of WMD=-0.28,Z=0.91,P=0.36,95%CI：-0.88^-0.32）.The length of stay in total thoracoscopic treatment was significantly shorter than muscle sparing surgery（P0.00001,WMD=-4.30,Z=7.37,95%CI：-5.45^-3.16）,and the adverse reactions were less than preserved muscle sparing surgery（OR=0.25,Z=5.63,P0.00001,95%CI：0.15 to 0.40）.Conclusion Compared with the Muscle sparing surgery,there was no significant difference in the number of lymph node dissection in thoracoscopic treatment of non-small cell lung cancer,but there was a significant advantage in postoperative recovery,and the safety was high.