吲哚菁绿荧光实时成像技术在腹腔镜肝切除术中应用效果的Meta分析

Meta-analysis of the effect of indocyanine green fluorescence real time imaging in laparoscopic hepatectomy

目的:采用Meta分析方法评价吲哚菁绿荧光实时成像技术在腹腔镜肝切除术中的应用效果。方法:以laparoscopic、hepatectomy、indocyanine green、fluorescence、腹腔镜、肝切除、吲哚菁绿、荧光为检索词,计算机检索中国知网、万方医学网、维普期刊网、中国生物医学文献数据库、Cochrane Library、PubMed、Embase、Web of Science等数据库,检索对比荧光腹腔镜肝切除术与传统腹腔镜肝切除术的队列研究及随机对照研究,按照预先设定的纳入与排除标准筛选文献、评估文献质量并提取数据。采用RevMan 5.3软件对提取的数据进行Meta分析,采用Stata 16进行发表偏倚评价。结果:最终纳入15篇文献,均为回顾性队列研究,共1299例患者。Meta分析结果显示,与传统腹腔镜肝切除术相比,荧光腹腔镜肝切除术R0切除率提高(OR=4.49,P<0.05),手术时间(MD=-18.32,P<0.05)、术后住院时间(MD=-1.33,P<0.05)缩短;术中出血量减少(MD=-39.77,P<0.05),术后并发症发生率低(OR=0.64,P<0.05)。结论:与传统腹腔镜手术相比,荧光腹腔镜在肝切除术中的应用效果较好,手术安全、可行,值得推广。

Objective:To evaluate the effect of indocyanine green real-time fluorescence imaging in laparoscopic hepatectomy by meta-analysis.Methods:The search terms included laparoscopic,hepatectomy,indocyanine green,fluorescence,laparoscopy,hepatectomy,indocyanine green and fluorescence.The databases of CNKI,Wanfang,VIP,CBM,Cochrane Library,PubMed,Embase and Web of Science were searched by computer.The cohort studies and randomized controlled trial about comparison of fluorescence laparoscopic hepatectomy and traditional laparoscopic hepatectomy were searched.According to pre-set inclusion and exclusion criteria,literatures were screened,literature quality was evaluated and data was extracted.The RevMan 5.3 software was used for meta-analysis of the extracted data,and publication bias was evaluated by Stata 16.Results:A total of 15 articles were included,all were retrospective cohort studies with a total of 1299 patients.Results of meta-analysis showed that fluorescence laparoscopic hepatectomy increased R0 resection rate when compared with traditional laparoscopic hepatectomy(OR=4.49,P<0.05),also showed its benefits in the operative time(MD=-18.32,P<0.05),postoperative hospitalization time(MD=-1.33,P<0.05),the intraoperative blood loss(MD=-39.77,P<0.05)and the incidence of postoperative complications(OR=0.64,P<0.05).Conclusions:Fluorescent laparoscopy has a superior effect in hepatectomy than traditional laparoscopy,and it is safe and feasible,worthy of widespread adoption.