Ivor-Lewis术式与Sweet术式治疗食管癌比较研究的Meta分析

发布时间：2018-04-20 23:41

本文选题：食管癌 + 食管切除术　；参考：《新疆医科大学》2015年硕士论文

【摘要】：目的：比较食管癌切除手术Ivor-Lewis术式与Sweet术式的有效性和安全性,探讨食管癌切除术的最佳手术方式。方法：检索PubMed、EMbase、the Cochrane Library、 Google scholar、中国知网(CNKI)、中国生物医学文献总库(CBM)、维普数据库(VIP)及万方数据库公开发表的Ivor-Lewis术式与Sweet术式比较的研究,采用RevMan 5.3软件进行数据分析。结果：14篇文献共3922例患者纳入研究,其中Ivor-Lewis组1322例,Sweet组2600例。Meta分析结果显示,与Sweet组比较,Ivor-Lewis组手术时间明显较长(MD=57.40,95%CI:42.43～72.38,P=0.000),手术出血量明显较高(MD=28.39,95%CI:4.06～52.72,P=0.02),淋巴结清扫数目明显较多(MD=4.19,95%CI:3.06～5.32,P=0.000);两组喉返神经损伤、乳糜胸、肺部并发症和吻合口瘘等并发症的发生情况差异无统计学意义(均P0.05)；两组间5年生存率差异无统计学意义(P=0.60)。结论：两种术式远期疗效相当,Sweet术式较Ivor-Lewis术式操作方便,节省手术时间,患者耐受性较好；Ivor-Lewis术式比Sweet术式能够清扫更多的淋巴结,亦未增加术后并发症。
[Abstract]:Objective: To compare the effectiveness and safety of Ivor-Lewis and Sweet in resection of esophageal cancer, and to explore the best surgical methods for esophagectomy. Methods: retrieve PubMed, EMbase, the Cochrane Library, Google scholar, Chinese knowledge network (CNKI), Chinese biologic Library (CBM), VP database (VIP) and Wanfang database. The study of the comparison of Ivor-Lewis and Sweet by RevMan 5.3 software was used to analyze the data. Results: 3922 patients in 14 papers were included in the study, of which 1322 cases were in group Ivor-Lewis, and 2600 cases in group Sweet showed that compared with group Sweet, the operation time of Ivor-Lewis group was significantly longer (MD=57.40,95%CI:42.43 ~ 72.38). P=0.000), the amount of bleeding was significantly higher (MD=28.39,95%CI:4.06 ~ 52.72, P=0.02), and the number of lymph nodes was significantly higher (MD=4.19,95%CI:3.06 ~ 5.32, P=0.000), and there was no significant difference between the two groups of recurrent laryngeal nerve injury, chylothorax, pulmonary complications and anastomotic fistula (P0.05), and the difference of 5 year survival rates between the two groups was different. There was no statistical significance (P=0.60). Conclusion: the long-term effect of the two kinds of surgical procedures was equal. The Sweet operation was more convenient than the Ivor-Lewis operation, saved the operation time and the patient was well tolerated; the Ivor-Lewis operation was able to clear more lymph nodes and no postoperative complications than the Sweet operation.

【学位授予单位】：新疆医科大学
【学位级别】：硕士
【学位授予年份】：2015
【分类号】：R735.1

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