单孔胸腔镜和多孔胸腔镜在肺癌治疗上的系统性回顾和meta分析

发布时间：2018-06-12 11:14

本文选题：单孔胸腔镜 + 多孔胸腔镜　；参考：《昆明医科大学》2017年硕士论文

【摘要】：[目的] 系统评价单孔胸腔镜(single-incision thoracoscopic surgery,SITS)和多孔胸腔镜在肺癌治疗上的疗效,评估单孔胸腔镜的安全性和可行性。[方法]计算机检索 PubMed, Cochrane Library,Springer Link 和 Science Direct等数据库,收集单孔胸腔镜和多孔胸腔镜治疗肺癌的随机对照研究和非随机研究,评估项目包括手术时间,术中出血量,胸管引流时间,术后住院日,淋巴结清扫个数和术后并发症的发生率。检索时限均为建库至2016年12月30日,由两位研究者独立筛选文献,提取资料和评价纳入研究的偏移风险后,采用RevMan 5.0 (Cochrane Collaboration, Oxford,UK)和 STATA 11.2 软件(StataCorp,College Station, Texas USA)来进行统计分析。[结果]共纳入11个研究,1314名病人。Meta分析结果显示:与多孔胸腔镜手术相比,单孔胸腔镜术后住院时间更短[WMD=0.50d,95%CI(-0.87,-0.13),p=0.008]和术后并发症的发生率更低[OR=0.64,95%CI(0.45,0.90),p=0.009],p=0.009],但两组在手术时间[WMD=9.39min,95%CI(-7.48,26.26),p=0.28],术中出血量[WMD=-7.700mL,95%CI(-20.02,4.62),p=0.22],胸腔引流时间[WMD=-0.72d,95%CI(-1.44,0.002),p=0.051]和淋巴结清扫个数[WMD=-0.45,95%CI(-1.03,0.13),p=0.13]方面,差异无统计学意义。[结论]单孔胸腔镜在肺癌外科治疗上比起多孔胸腔镜在缩短住院时间和降低术后并发症的发生更有优势,单孔胸腔镜可被视为在肺癌外科治疗中代替多孔胸腔镜一种安全可行的方法。
[Abstract]:[objective] to evaluate the efficacy and safety of single-hole thoracoscopic thoracoscopy (SITSs) and porous thoracoscopy in the treatment of lung cancer, and to evaluate the safety and feasibility of single-hole thoracoscopy. [methods] PubMed, Cochrane LibrarySpringer Link and Science Direct databases were searched by computer to collect randomized controlled and non-randomized studies for the treatment of lung cancer by single hole thoracoscopy and porous thoracoscopy. The evaluation items included operative time and intraoperative bleeding. Time of thoracic drainage, length of hospitalization, number of lymph node dissection and incidence of postoperative complications. The retrieval time is from the date of establishment until December 30, 2016. After the two researchers independently sifted the literature, extracted the data and evaluated the migration risk in the study, the statistical analysis was carried out by RevMan 5.0 Cochrane collaboration (Oxford UK) and StataCorpton College Stationation, Texas USA. the STATA 11.2 software was used to carry out the statistical analysis. [results] A meta-analysis of 1314 patients in 11 studies showed that compared with thoracoscopic surgery, 鍗曞瓟鑳歌厰闀滄湳鍚庝綇闄㈡椂闂存洿鐭璠WMD=0.50d,95%CI(-0.87,-0.13),p=0.008]鍜屾湳鍚庡苟鍙戠棁鐨勫彂鐢熺巼鏇翠綆[OR=0.64,95%CI(0.45,0.90),p=0.009],浣嗕袱缁勫湪鎵嬫湳鏃堕棿[WMD=9.39min,95%CI(-7.48,26.26),p=0.28],鏈腑鍑鸿閲廩WMD=-7.700mL,95%CI(-20.02,4.62),p=0.22],鑳歌厰寮曟祦鏃堕棿[WMD=-0.72d,95%CI(-1.44,0.002),p=0.051]鍜屾穻宸寸粨娓呮壂涓暟[WMD=-0.45,95%CI(-1.03,0.13),p=0.13]鏂归潰,宸紓鏃犵粺璁″鎰忎箟. [conclusion] Single-hole thoracoscopy is superior to porous thoracoscopy in shortening hospital stay and reducing postoperative complications in the surgical treatment of lung cancer. Single-hole thoracoscopy can be regarded as a safe and feasible method to replace porous thoracoscopy in the surgical treatment of lung cancer.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R734.2

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