同时性结直肠癌肝转移同期与分期手术切除疗效与安全性的Meta分析

Efficiency and safety of simultaneous resection vs staged resection on in colorectal carcinoma with synchronous liver metastasis：a meta-analysis

目的对同时性结直肠癌肝转移患者行同期手术切除与分期手术切除的安全性和有效性进行评估。方法系统检索2000年1月至2017年7月PubMed、Embase、CochraneLibrary、OVID、WebofScience、万方、中国生物医学、维普、知网数据库中发表的相关文献，应用RevMan5．3分别对围手术期并发症、术后死亡率及5年生存率进行荟萃分析。结果25篇回顾性研究共5631例患者符合标准，分析显示：两组患者在围手术期并发症（OR=0．90，P=0．39）、术后死亡率（OR=1．23，P=0．29）及5年生存率（OR=1.03，P=0．68）比较差异均无统计学意义。结论相比分期手术切除，同时性结直肠癌肝转移患者行同期手术切除是同样安全有效的；由于较低水平的证据和异质性的存在，应具体分析个体情况。

Objective To compare the safety and efficiency between simultaneous resection and staged resection of synchronous colorectal liver metastases. Methods A systematic literature search was performed in PubMed, Embase, Cochrane Library, OVID, Web of Science, WanFang Data, CBM,VIP and CNK1 databases for relevant articles published from January 2000 to July, 2017. The meta-analysis was performed by RevMan 5.3. The primary outcomes were peri-operative complications, postoperative mortality, five-year survival rate. Results 25 studies with a total of 5 631 patients were finally included. The results of meta-analysis showed that simultaneous and staged resections were similar in peri-operative complications （ OR = 0. 90, P = 0. 39 ）, postoperative mortality （ OR = 1.23, P = 0. 29 ） and five-year survival rate （ OR = 1.03, P = 0. 68）. Conclusions Simultaneous resection is safe and efficient in the treatment of patients with SCLMs. However, the results should be interpreted and applied prudently due to the lower level of evidence and the existence of heterogeneity.