腹腔镜手术治疗早期卵巢癌有效性与安全性的Meta分析
发布时间：2018-11-08 16:56
【摘要】：目的：评价腹腔镜在早期卵巢癌全面分期手术中的安全性、有效性，为临床实践提供可靠依据。 方法：计算机检索Ovid、EMbase、PubMed、CBM、CNKI、万方期刊全文数据库等。以 ovarian cancer‖, ovarian carcinoma‖, earlystage‖, laparoscopy‖, stagingsurgery‖, staging laparoscopy‖,为英文检索词，以 腹腔镜、开腹手术、分期手术、早期卵巢癌、卵巢癌、腹腔镜分期手术‖为中文检索词进行检索。按照纳入标准与排除标准收集相关文献，由俩名评价员分别独立阅读检索文献的题目和摘要后，删除显著不满足纳入标准的文献后，对于满足纳入标准的文献进行全文阅读，确定最终是否真正被纳入，俩名评价员交叉核对。如遇分歧，通过请教统计学专业人员解决。数据的统计分析使用Cochrane协作网提供的RevMan5.2软件进行。 结果：根据入选及排除标准共纳入文献12篇，其中中文文献7篇，英文文献5篇，均采用平行设计，且均为非随机对照研究。共纳入753例早期卵巢癌患者，腹腔镜组314例，开腹组439例。所纳入文献均对受试者特征如年龄、体重指数、临床分期等进行描述且无统计学差异。Meta分析的结果显示：腹腔镜组手术时间长、但术中出血量少、术后肠功能恢复快、住院时间短、围手术期并发症少，两组比较有统计学意义（手术时间：WMD=38.2795%CI：10.03～66.51,P=0.008；术中出血量：WMD=㧟223.29，95%CI：㧟324.09～㧟123.09，P＜0.0001；术后排气时间：SMD=㧟1.79，95%CI：㧟2.30～㧟1.29，P＜0.00001；术后住院时间：WMD=㧟4.87，95%CI：㧟6.70～㧟3.05，，P＜0.00001；围手术期并发症：OR=0.43，95%CI：0.26～0.71，P=0.0009；）；而复发率、盆腔淋巴结、腹主动脉旁淋巴结切除数目相比差异无统计学意义（术后复发率：OR=0.54，95%CI：0.18～1.57，P=0.26；盆腔淋巴结切除个数：WMD=㧟1.80，95%CI：㧟3.91～0.32,P=0.10；腹主动脉旁淋巴结切除个数：WMD=1.22，95%CI：-0.81～3.24，P=0.24）。 结论：腹腔镜是一个治疗早期卵巢癌手术效果较满意，安全、有效的选择，且具有创伤小、住院时间短、围手术期并发症少的优点，目前RCT(randomizedcontrolled trials,随机对照试验)较少，多中心研究的前瞻性的随机对照试验更少，故本研究所得出的结论尚需更多高质量研究进一步鉴证。
[Abstract]:Objective: to evaluate the safety and efficacy of laparoscopy in the early stage operation of ovarian cancer, and to provide reliable basis for clinical practice. Methods: the full text database of Ovid,EMbase,PubMed,CBM,CNKI, Wanfang periodical was searched by computer. Ovarian cancer, ovarian carcinoma, earlystage, laparoscopy, stagingsurgery, staging laparoscopy were used as English key words. The Chinese key words were laparoscopy, open surgery, staging operation, early ovarian cancer and laparoscopic staging operation. The relevant documents were collected according to the inclusion criteria and exclusion criteria. After the two evaluators read the titles and abstracts of the retrieval documents independently, after deleting the documents that did not meet the inclusion criteria, they read the full text of the documents that met the inclusion criteria. To determine whether or not they are actually included, the two evaluators cross check. In the event of disagreement, by consulting a statistical professional to resolve. The statistical analysis of the data is carried out by RevMan5.2 software provided by the Cochrane Cooperative Network. Results: according to the criteria of inclusion and exclusion, 12 articles were included, of which 7 were in Chinese and 5 in English. All of them were designed in parallel design and were all non-randomized controlled studies. A total of 753 cases of early ovarian cancer were included, including 314 cases in laparoscopic group and 439 cases in open group. The results of Meta analysis showed that the laparoscopic group had a long operation time, but less blood loss during the operation, and the intestinal function recovered quickly after operation, and there was no significant difference between the two groups in terms of age, body mass index and clinical stage. The duration of hospitalization was short and the complications were less in perioperative period. There was significant difference between the two groups (operative time: WMD=38.2795%CI:10.03~66.51,P=0.008;). Intraoperative bleeding volume: WMD=?223.29,95%CI:?324.09~?123.09,P < 0.0001, postoperative exhaust time: SMD=?1.79,95%CI:?2.30~?1.29,P < 0.00001; Postoperative hospitalization time: WMD=?4.87,95%CI:?6.70~?3.05,P < 0.00001; perioperative complications: OR=0.43,95%CI:0.26~0.71,P=0.0009;); However, there was no significant difference in the recurrence rate, pelvic lymph nodes, and the number of para-aortic lymphadenectomies (postoperative recurrence rate: OR=0.54,95%CI:0.18~1.57,P=0.26;). Pelvic lymph node resection number: WMD=?1.80,95%CI:?3.91~0.32,P=0.10; abdominal aorta lymph node resection number: WMD=1.22,95%CI:-0.81~3.24,P=0.24). Conclusion: laparoscopy is a satisfactory, safe and effective choice in the treatment of early ovarian cancer. It has the advantages of less trauma, shorter hospital stay and less perioperative complications. At present, RCT (randomizedcontrolled trials, randomized controlled trial is less. There are fewer prospective randomized controlled trials in multicenter studies, so the findings of this study need to be further corroborated by high-quality studies.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31
本文编号：2319114
[Abstract]:Objective: to evaluate the safety and efficacy of laparoscopy in the early stage operation of ovarian cancer, and to provide reliable basis for clinical practice. Methods: the full text database of Ovid,EMbase,PubMed,CBM,CNKI, Wanfang periodical was searched by computer. Ovarian cancer, ovarian carcinoma, earlystage, laparoscopy, stagingsurgery, staging laparoscopy were used as English key words. The Chinese key words were laparoscopy, open surgery, staging operation, early ovarian cancer and laparoscopic staging operation. The relevant documents were collected according to the inclusion criteria and exclusion criteria. After the two evaluators read the titles and abstracts of the retrieval documents independently, after deleting the documents that did not meet the inclusion criteria, they read the full text of the documents that met the inclusion criteria. To determine whether or not they are actually included, the two evaluators cross check. In the event of disagreement, by consulting a statistical professional to resolve. The statistical analysis of the data is carried out by RevMan5.2 software provided by the Cochrane Cooperative Network. Results: according to the criteria of inclusion and exclusion, 12 articles were included, of which 7 were in Chinese and 5 in English. All of them were designed in parallel design and were all non-randomized controlled studies. A total of 753 cases of early ovarian cancer were included, including 314 cases in laparoscopic group and 439 cases in open group. The results of Meta analysis showed that the laparoscopic group had a long operation time, but less blood loss during the operation, and the intestinal function recovered quickly after operation, and there was no significant difference between the two groups in terms of age, body mass index and clinical stage. The duration of hospitalization was short and the complications were less in perioperative period. There was significant difference between the two groups (operative time: WMD=38.2795%CI:10.03~66.51,P=0.008;). Intraoperative bleeding volume: WMD=?223.29,95%CI:?324.09~?123.09,P < 0.0001, postoperative exhaust time: SMD=?1.79,95%CI:?2.30~?1.29,P < 0.00001; Postoperative hospitalization time: WMD=?4.87,95%CI:?6.70~?3.05,P < 0.00001; perioperative complications: OR=0.43,95%CI:0.26~0.71,P=0.0009;); However, there was no significant difference in the recurrence rate, pelvic lymph nodes, and the number of para-aortic lymphadenectomies (postoperative recurrence rate: OR=0.54,95%CI:0.18~1.57,P=0.26;). Pelvic lymph node resection number: WMD=?1.80,95%CI:?3.91~0.32,P=0.10; abdominal aorta lymph node resection number: WMD=1.22,95%CI:-0.81~3.24,P=0.24). Conclusion: laparoscopy is a satisfactory, safe and effective choice in the treatment of early ovarian cancer. It has the advantages of less trauma, shorter hospital stay and less perioperative complications. At present, RCT (randomizedcontrolled trials, randomized controlled trial is less. There are fewer prospective randomized controlled trials in multicenter studies, so the findings of this study need to be further corroborated by high-quality studies.
【学位授予单位】：大连医科大学
【学位级别】：硕士
【学位授予年份】：2014
【分类号】：R737.31
【参考文献】
相关期刊论文 前7条
1 赵倩;边爱平;刘荣欣;;腹腔镜与开腹治疗早期卵巢癌的对比分析[J];医药论坛杂志;2012年01期
2 李宏;;腹腔镜与开腹手术治疗早期卵巢癌的对比分析[J];吉林医学;2012年13期
3 蒋宇林,郎景和,冷金花,刘东远;体外模拟的二氧化碳气腹环境对卵巢癌细胞增殖的影响[J];现代妇产科进展;2004年02期
4 华克勤,金福明,徐焕,朱芝玲,林金芳,丰有吉;腹腔镜手术治疗早期低危型卵巢恶性肿瘤的价值[J];中华医学杂志;2005年03期
5 郝婷;李萌;熊光武;宋晓晨;郭红燕;张璐芳;韩劲松;朱馥丽;郭文萍;;早期卵巢癌腹腔镜与开腹分期手术的对比分析[J];中国微创外科杂志;2010年03期
6 刘琛姝;王永莉;潘玉韵;;腹腔镜手术和开腹手术在早期卵巢肿瘤分期探查术中的应用效果及术后并发症比较[J];新乡医学院学报;2012年10期
7 杨萍;王英红;李丰玲;付睿婷;;腹腔镜在早期卵巢癌全面分期手术中的应用价值[J];中国内镜杂志;2012年10期
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