根治性全胃切除术及根治性近端胃切除术治疗贲门癌疗效的Meta分析

发布时间：2018-04-26 06:34

本文选题：贲门癌 + 根治性全胃切除术　；参考：《兰州大学》2017年硕士论文

【摘要】：目的系统评价根治性全胃切除术及根治性近端胃切除术治疗贲门癌的疗效及并发症。方法计算机检索PubMed、Web of Science、The Cochrane Library、中国生物医学文献数据库、万方数据库和中国知网等数据库,查找关于根治性全胃切除术及根治性近端胃切除术治疗贲门癌的相关研究文献,检索时限均从建库至2016年10月18日。由2位评价员按纳入与排除标准独立筛选文献、提取资料并评价质量后,采用RevMan 5.3软件进行Meta分析。结果共纳入8个研究,522例患者。Meta分析结果显示:与根治性近端胃切除术相比,根治性全胃切除术治疗贲门癌在5年生存率[OR=1.84,95%CI(1.16,2.92),P=0.01]、3年生存率[OR=1.95,95%CI(1.30,2.93),P=0.001]、吻合口瘘发生率[OR=0.39,95%CI(0.16,0.94),P=0.03]、反流发生率[OR=0.12,95%CI(0.04,0.36),P=0.0002]方面差异均有统计学意义。在1年生存率[OR=1.31,95%CI(0.66,2.60),P=0.44]、吻合口狭窄发生率[OR=0.53,95%CI(0.16,1.69),P=0.28]、肠梗阻发生率[OR=0.39,95%CI(0.14,1.09),P=0.07]、切口感染发生率[OR=0.79,95%CI(0.19,3.33),P=0.75]方面差异无统计学意义。结论现有证据表明,全胃切除术治疗贲门癌效果良好且并发症少。鉴于纳入研量有限,上述结论尚需开展更多研究予以验证。
[Abstract]:Objective to evaluate the efficacy and complications of radical total gastrectomy and radical proximal gastrectomy in the treatment of cardiac carcinoma. Methods We searched the online database of PubMedus Web of Science of the Cochrane Library, the Chinese Biomedical Literature Database, the Wanfang Database and the Chinese knowledge Network, and searched for the relevant literatures on radical total gastrectomy and radical proximal gastrectomy in the treatment of cardiac carcinoma. The time limit for retrieval is from the construction of the database to October 18, 2016. According to the inclusion and exclusion criteria, two evaluators independently sifted the literature, extracted the data and evaluated the quality, and then analyzed the data by RevMan 5.3 software. Results A total of 522 patients were included in 8 studies. Meta-analysis showed that compared with radical proximal gastrectomy, The 5-year survival rate of radical total gastrectomy for cardiac cancer [OR1.8495 CIQ 1.162.92], the 3-year survival rate (OR1.9595CII 1.302.93P0.001), the incidence of anastomotic fistula (OR0.3995CI0.160.94P0.03), the incidence of reflux [OR0.1295CI0.040.36Pn002] were statistically significant. There was no significant difference in the incidence of anastomotic stenosis (OR0.53 / 95), intestinal obstruction (OR0.39 / 95CII 0.141.09P0.07), incisional infection (OR0.799CII 0.193.33P0.75) at 1 year survival rate [OR1. 31C 95 CIQ], anastomotic stoma stenosis rate (OR0. 5395 CII = 0. 669 P0. 28), and incisional infection rate (OR0.79 / 95CIT = 0. 193.33P0. 75), and there was no significant difference in the incidence of intestinal obstruction (OR 0.39 / 95 CII = 0.141.09 P0.07), and there was no significant difference in the incidence of incisional infection [OR0.79 / 95CIT 0.193.33P0.75] Conclusion the available evidence shows that total gastrectomy is effective in treating cardiac carcinoma with less complications. In view of the limited number of studies included, more studies are needed to verify the above conclusions.
【学位授予单位】：兰州大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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