肥胖因素影响腹腔镜肾癌根治术手术疗效的系统评价与荟萃分析

发布时间：2018-09-07 21:48

【摘要】：目的:肥胖因素对腹腔镜肾癌根治术手术的安全性与可行性的影响一直存在争议,本研究将系统评价肥胖因素对腹腔镜肾癌根治术疗效的影响。方法:检索PubMed,Web of Science,Embase,Cochrane Library,Wiley Online Library,SpringerLink,Elsevier,EBSCO,and Ovid等9个外文数据库,检索时间为自建库至2017年2月,搜索有关肥胖因素对腹腔镜肾癌根治术影响的随机或非随机对照试验文献,并筛检纳入文献的参考文献,严格按照PRISMA原则筛选后,评估文献质量并提取相关数据资料,采用Review Manager 5.3软件进行系统评价。结果:最终纳入9篇文献进行研究,其中5篇来自美国、4篇来自亚洲,均为回顾性研究的非随机对照试验文献。总共纳入1039例参与研究,其中肥胖组365例,非肥胖组674例。Meta分析结果发现:(1)肥胖组较非肥胖组手术时间明显延长(欧美p0.00001,WMD:49.21 min,95%CI:35.97 to 62.45;亚洲p0.00001,WMD:26.94 min,95%CI:19.04 to 34.85;overall WMD:32.80 min,95%CI:26.01 to 39.58,p0.00001)及术中出血量显著增多(欧美p=0.03,WMD:34.02 ml,95%CI:3.95 to 64.09;亚洲p0.00001,WMD:49.61 ml,95%CI:42.32 to 56.91;overall WMD:48.75 ml,95%CI:41.66 to 55.83,p0.00001);(2)肥胖组术中输血率(欧美p=0.27,亚洲p=0.27),住院时间(欧美p=0.37,亚洲p=0.87),中转开放率(欧美p=0.27,亚洲p=0.11),并发症(严重并发症p=0.97,非严重并发症p=0.54),初次进食流汁时间(欧美p=0.94,亚洲p=0.72),初次下床活动时间(欧美p=0.14,亚洲p=0.42)差异无统计学意义。结论:对于肥胖患者而言,尽管腹腔镜肾癌根治术手术时间较长、术中出血量偏多,但依然是安全可行的。
[Abstract]:Objective: the influence of obesity factors on the safety and feasibility of laparoscopic radical renal cell carcinoma surgery has been controversial. Methods: nine foreign language databases, including PubMed,Web of Science,Embase,Cochrane Library,Wiley Online Library,SpringerLink,Elsevier,EBSCO,and Ovid, were searched for random or non-randomized controlled trials on the effects of obesity factors on laparoscopic radical renal cell carcinoma surgery until February 2017. The references included in the literature were screened strictly according to the PRISMA principle, the quality of the literature was evaluated and the relevant data were extracted, and the systematic evaluation was carried out with the software of Review Manager 5.3. Results: nine articles were included in the study, of which 5 were from the United States and 4 were from Asia, all of which were non-randomized controlled trial literatures of retrospective study. A total of 1039 subjects were enrolled in the study. 闈炶偉鑳栫粍674渚，

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