腹腔镜和开腹手术治疗早期宫颈癌疗效对比的系统评价

发布时间：2018-01-26 00:03

本文关键词： 宫颈癌腹腔镜子宫根治术开腹子宫根治术系统评价 Meta分析　出处：《肿瘤防治研究》2017年03期 　论文类型：期刊论文

【摘要】：目的系统地评价早期宫颈癌腹腔镜手术治疗的疗效及安全性。方法计算机检索CENTRAL(Cochrane图书馆2016年第3期)、MEDLINE、EMBASE、PUBMED、CNKI、Wan Fang、VIP、CBM数据库,并手工检索相关未发表的灰色文献,查找比较腹腔镜与开腹手术治疗早期宫颈癌的随机对照试验(RCTs)和非随机临床对照试验(CCTs)。由2位研究者按照纳入排除标准筛选文献、评价质量并提取资料后,采用Rev Man 5.1软件进行Meta分析。结果纳入1个RCT和5个CCTs,共322例早期宫颈癌患者。结果显示:与开腹手术相比,腹腔镜手术具有缩短住院时间及减少术中出血量的优势,同时具有手术时间延长的劣势,两组在3年总生存率、3年复发率、术中、术后并发症及盆腔淋巴结切除数目方面,差异均无统计学意义(均P0.05)。结论腹腔镜手术治疗早期宫颈癌在缩短住院时间及减少术中出血方面优于开腹手术,但缺乏术后长期结局指标特别是生活质量的评价结果。
[Abstract]:Objective to evaluate the efficacy and safety of laparoscopic surgery in the treatment of early cervical cancer. Methods CENTRAL(Cochrane Library issue 3 of 2016 was searched by computer. MEDLINE EMBASE was used to search the CBM database of CNKI Wan Fangli, and the relevant grey literature was searched by hand. A randomized controlled trial (RCTs) and a non-randomized clinical controlled trial (CCTsP) were compared between laparoscopic and open surgery for early cervical cancer. The literature was screened by two researchers according to the exclusion criteria. After evaluating the quality and extracting the data, Meta analysis was carried out with Rev Man 5.1 software. The results included 1 RCT and 5 CCTs. A total of 322 patients with early cervical cancer were treated with laparoscopy. The results showed that laparoscopic surgery had the advantages of shortening the hospitalization time and reducing the amount of intraoperative bleeding, and had the disadvantage of prolonging the operation time. The overall 3-year survival rate, 3-year recurrence rate, intraoperative complications and the number of pelvic lymphadenectomy were observed in both groups. Conclusion Laparoscopic surgery is superior to open surgery in shortening hospitalization time and reducing intraoperative bleeding. However, there is a lack of long-term outcome indicators, especially the quality of life evaluation results.
【作者单位】：广西医科大学附属肿瘤医院妇瘤科区域性高发肿瘤早期防治研究教育部重点实验室;广西柳州市工人医院妇瘤病区;
【基金】：广西自然科学基金(2014GXNSFAA118147) 广西壮族自治区卫生和计划生育委员会科研课题(Z2015626) 广西壮族自治区柳州市科技局科研课题(2015J030508)
【分类号】：R737.33
【正文快照】： 0引言宫颈癌是女性常见恶性肿瘤之一,其发病率仅次于乳腺癌而位居第二[1]。在欧洲,诊断为宫颈癌的女性大约有60%可存活5年以上[2]。Wertheim[3]于1900年报道了第一例开腹子宫切除治疗早期宫颈癌。目前,开腹子宫根治术或PiverⅢ型子宫切除联合盆腔淋巴结切除术已成为国际妇产科

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