腹腔镜腹膜外途径淋巴结切除术在妇科三大恶性肿瘤中安全性和有效性的meta分析

发布时间：2018-10-11 17:43

【摘要】：目的该研究的目的是通过回顾现有文献,比较腹腔镜腹膜外途径和腹膜内途径行淋巴结切除术在妇科三大恶性肿瘤中的安全性及有效性。方法彻底而系统的检索Pub Med、EMBASE、Cochrane、Scopus数据库、中国知网(CNKI)、中国医学文献数据库(CBM)及万方医学数据库等数据库,检索时间限定为:建库至2017年2月;手工检索相关杂志和著作,搜集国内外符合纳入标准的非随机对照试验。干预措施为:所有患者行腹腔镜手术,试验组采用腹膜外途径淋巴结切除术,对照组采用腹膜内途径淋巴结切除术。观察指标包括:手术时间、术中出血量、淋巴囊肿发生率、术中及术后并发症发生率、淋巴结切除总数。采用Rev Man 5.3软件对纳入的研究进行Meta分析。结果共纳入7个符合要求的非随机对照试验,共计539例患者(其中腹膜外组271例,腹膜内组268例)。与腹膜内组相比,腹膜外组手术时间短,淋巴囊肿发生率、术中和术后并发症发生率低;但在术中出血和淋巴结切除数目方面,两组无明显差异。结论在妇科三大恶性肿瘤腹腔镜淋巴结切除手术中,腹膜外途径较腹膜内途径在手术时间、淋巴囊肿发生率、术中和术后并发症发生率等方面有明显的优势,术中出血、腹主动脉旁淋巴结切除数目两者相当。
[Abstract]:Objective to compare the safety and efficacy of laparoscopic extraperitoneal and intraperitoneal lymphadenectomy in three gynecological malignancies. Methods complete and systematic retrieval of Pub Med,EMBASE,Cochrane,Scopus database, (CNKI), database of Chinese medical literature, (CBM) and Wanfang medical database, etc., were carried out thoroughly and systematically. The retrieval time was limited to the following: the database was built until February 2017, and the related magazines and works were searched manually. Collect non-randomized controlled trials that meet the inclusion criteria at home and abroad. The intervention measures were as follows: all patients underwent laparoscopic surgery, the experimental group received extraperitoneal lymphadenectomy and the control group underwent intraperitoneal lymphadenectomy. The parameters included: operative time, intraoperative bleeding, incidence of lymphocyst, intraoperative and postoperative complications, total lymph node resection. Rev Man 5.3 software was used to analyze the included research by Meta. Results A total of 539 patients (271 in extraperitoneal group and 268 in intraperitoneal group) were enrolled in 7 non-randomized controlled trials. Compared with the intraperitoneal group, the extraperitoneal group had shorter operation time, lower incidence of lymphocyst, and lower incidence of intraoperative and postoperative complications, but there was no significant difference in the number of intraoperative bleeding and lymph node resection between the two groups. Conclusion in laparoscopic lymphadenectomy for three major gynecological malignancies, the extraperitoneal approach is superior to the intraperitoneal approach in terms of the operative time, the incidence of lymphocysts, the incidence of complications during and after operation, and the intraoperative bleeding. The number of lymphadenectomies around the abdominal aorta was the same.
【学位授予单位】：广西医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R737.3

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