3D与2D腹腔镜下肾部分切除术疗效与安全性的Meta分析

Efficacy and safety of 3D versus 2D laparoscopic partial nephrectomy:a Meta-analysis

目的应用Meta分析评价3D腹腔镜与2D腹腔镜下肾部分切除术的疗效与安全性。方法计算机检索PubMed、Medline、Cochrane library、Embase、Web of science、中国期刊全文数据库(CNKI)、维普医学数据库、万方数据库及中国生物医学文献数据库从建库至2020年10月的文献资料,采用RevMan 5.3.0对纳入研究的数据进行Meta分析。结果纳入了19篇文献,共1269例患者,其中3D腹腔镜组586例,2D腹腔镜组683例。Meta分析显示,与2D腹腔镜组相比,3D腹腔镜组在手术时间(MD=-15.51,95%CI:-19.92~-11.11,P<0.001)、术中出血量(MD=-8.31,95%CI:-14.74~-1.89,P=0.01)、热缺血时间(MD=-4.79,95%CI:-6.73~-2.85,P<0.001)、住院时间(MD=-0.32,95%CI:-0.46~-0.17,P<0.001)差异有统计学意义,而在并发症发生率、术后肌酐方面差异无统计学意义(P>0.05)。结论与2D腹腔镜相比,3D腹腔镜下肾部分切除术能够缩短手术时间和热缺血时间,减少术中出血量,在保护肾功能上具有一定优势,并且术后恢复较快,值得临床推广。

Objective To evaluate the efficacy and safety of 3D and 2D laparoscopic partial nephrectomy(LPN)with Meta-analysis.Methods Studies on 3D and 2D LPN were searched in PubMed,Medline,Cochrane Library,Embase,Web of Science,CNKI,Weipu Medical Database,Wanfang Database and China Biomedical Literature Database from inception to Oct.2020.Meta-analysis was performed on data with RevMan 5.3.0.Results A total of 19 studies involving 1269 patients were retrieved,including 586 in the 3D group and 683 in the 2D group.Meta-analysis showed that there were significant differences in operation time(MD=-15.51,95%CI:-19.92--11.11,P<0.001),intraoperative blood loss(MD=-8.31,95%CI:-14.74--1.89,P=0.01),warm ischemia time(MD=-4.79,95%CI:-6.73--2.85,P<0.001),hospital stay(MD=-0.32,95%CI:-0.46--0.17,P<0.001),but there were no significant differences in complication rate and postoperative creatinine.Conclusion Compared with 2D LPN,3D LPN can shorten operation time and warm ischemia time,reduce intraoperative blood loss,protect renal function,and promote postoperative recovery.It is worthy of clinical promotion.