完全电视胸腔镜手术与胸腔镜辅助小切口手术治疗早期非小细胞肺癌临床疗效的Meta分析
发布时间：2018-07-08 20:22
本文选题：肺肿瘤 + 完全电视胸腔镜手术 ； 参考：《中国肺癌杂志》2017年05期
【摘要】：背景与目的目前未见对全电视胸腔镜手术与胸腔镜辅助小切口手术治疗非小细胞肺癌临床疗效和安全性的系统评价。在本meta分析中,我们比较两组手术治疗非小细胞肺癌的临床效果。方法系统地检索7个主要的医学期刊数据库:PubMed、Embase、CNKI、VIP、ISI Web of Science、the Cochrane Library和CBM,收集时间涵盖2006年5月-2016年5月的有关完全电视胸腔镜手术与胸腔镜辅助小切口手术治疗非小细胞肺癌的随机对照研究(randomized controlled trials,RCT)。由两名研究者对文献质量独立进行评价并提取相关数据,采用Rev Man 5.3软件进行meta分析。结果共纳入13篇RCT,共1,605例患者。其中完全电视胸腔镜组(video-assisted thoracoscopic surgery,VATS)815例,胸腔镜辅助小切口组(video-assisted mini-thoracotomy,VAMT)790例。Meta分析结果显示:全胸腔镜手术与胸腔镜辅助小切口手术治疗非小细胞肺癌相比,手术时间(SMD=13.56,95%CI:4.96-22.16)、术中出血量(SMD=-33.68,95%CI:-45.70--21.66)、胸腔引流管留置时间(SMD=-1.05,95%CI:-1.48--0.62)、胸腔引流量(SMD=-83.69,95%CI:-143.33--24.05)、术后疼痛程度(SMD=-1.68,95%CI:-1.98--1.38)、术后住院时间(SMD=-2.27,95%CI:-3.23--1.31)、两组淋巴结清扫数目(SMD=-0.48,95%CI:-0.80--0.17)等方面的差异有统计学意义;而两组术中的并发症发生率(SMD=0.83,95%CI:0.54-1.29)、手术死亡率(SMD=0.95,95%CI:0.55-1.63)和1年复发率(RR=0.87,95%CI:0.34-2.24)差异无统计学意义(P0.05)。结论完全电视胸腔镜手术与胸腔镜辅助小切口切除术相比,治疗非小细胞肺癌的并发症发生率和手术死亡率相当,但二者在淋巴结清扫数目、手术时间、术中出血量、胸腔引流量、胸腔引流管留置时间、术后疼痛程度和术后住院时间等方面有差异。现有的临床资料显示:相比胸腔镜辅助小切口手术,全胸腔镜手术是治疗早期非小细胞肺癌更好的选择。
[Abstract]:Background and objective there is no systematic evaluation of the clinical efficacy and safety of total video-assisted thoracoscopic surgery and thoracoscopic assisted small-incision surgery in the treatment of non-small cell lung cancer (NSCLC). In this meta analysis, we compared the clinical outcomes of the two groups in the treatment of non-small cell lung cancer. Methods A systematic search of 7 major medical journal databases, called: PubMedbase, CNKIK, VIPISI Web of Science of the Cochrane Library and CBMs, was carried out for the period from May 2006 to May 2016 for the treatment of non-small cells with complete video-assisted thoracoscopic surgery and thoracoscopic assisted mini-incision surgery, covering the period from May 2006 to May 2016. Lung cancer: a randomized controlled study of (randomized controlled trialsm. The literature quality was evaluated independently by two researchers and the relevant data were extracted. The meta analysis was carried out by using Revman 5.3 software. Results A total of 13 RCTs were included, with a total of 1605 patients. There were 815 cases in video-assisted thoracoscopic vats group and 790 cases in video-assisted mini-thoracoscopic group. Meta-analysis showed that total thoracoscopic surgery was compared with thoracoscopic assisted small-incision surgery in the treatment of non-small cell lung cancer. 鎵嬫湳鏃堕棿(SMD=13.56,95%CI:4.96-22.16),鏈腑鍑鸿閲，
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