基于对照试验的单孔与多孔腹腔镜疝修补术系统评价研究

发布时间：2019-03-20 13:24

【摘要】：目的:荟萃分析单孔腹腔镜及传统腹腔镜腹膜外无张力修补术的安全性及可行性。方法:检索1989-2014相关期刊论文(CNKI)、维普中文期刊数据库、PubMed、The Cochrane Library以及EMBASE等数据库中,对单孔腹腔镜及传统腹腔镜腹膜外无张力修补术进行荟萃分析,按照纳入与排除标准选择试验、提取资料后,采用RevMan 5.2软件进行Meta分析,以P0.05为差异有统计学意义。结果:共10例研究纳入研究,单孔腹腔镜手术526人,传统腹腔镜手术462人,meta分析提示单孔腹腔镜单侧/双侧手术时间虽然明显长于传统腹腔镜腹膜外无张力修补术(WMD=7.72和9.66,P0.05),但是两组患者术后并发症、术后发生血肿、术后复发、术后住院时间差异没有统计学意义,两者安全性相当。结论:单孔腹腔镜下疝修补手术的围手术期安全性与传统腹腔镜腹膜外无张力修补术相比没有明显差异,在患者美观要求较高,且符合微创手术指征时可行单孔腹腔镜手术。但进一步结论亟待进一步大样本RCT研究证实。
[Abstract]:Objective: to evaluate the safety and feasibility of single-hole laparoscopy and conventional laparoscopic extraperitoneal tension-free repair. Methods: a meta-analysis of single-hole laparoscopy and traditional laparoscopic extraperitoneal tension-free repair was performed by searching the Chinese journal database of (CNKI), PubMed,The Cochrane Library and EMBASE in 1989 / 2014. According to the selection test of inclusion and exclusion criteria, after extracting the data, Meta analysis was carried out with RevMan 5.2 software, and the difference was statistically significant (P0.05). Results: a total of 10 cases were included in the study. 526 patients underwent single-hole laparoscopic surgery and 462 patients underwent traditional laparoscopic surgery. Meta analysis showed that the duration of unilateral / bilateral laparoscopic surgery was significantly longer than that of conventional laparoscopic extraperitoneal tension-free repair (WMD=7.72 and 9.66, P0.05), but there were postoperative complications, postoperative hematoma and postoperative recurrence in the two groups, and the operative time of unilateral / bilateral laparoscopic surgery was significantly longer than that of conventional laparoscopic extraperitoneal tension-free repair. There was no significant difference in postoperative hospital stay, and the safety of the two groups was the same. Conclusion: the peri-operative safety of single-hole laparoscopic inguinal hernia repair is not significantly different from that of traditional laparoscopic extraperitoneal tension-free repair. It is feasible to perform single-hole laparoscopic surgery when the patient's appearance is higher and accords with the indications of minimally invasive operation. However, further conclusions need to be confirmed by further large sample RCT studies.
【作者单位】：台山市人民医院普外科;中山大学附属第六医院结直肠外科;
【分类号】：R656.21

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