腹腔镜下保脾胰体尾切除术治疗胰体尾部肿瘤疗效的Meta分析

发布时间：2018-12-18 14:08

【摘要】：目的:系统性评价腹腔镜下保留脾脏的胰体尾切除术在胰体尾部肿瘤治疗中的临床疗效。方法:检索多个国内外文献数据库,根据纳入排除标准,筛选出符合要求的文献,提取数据并进行文献质量评价,应用RevMan 5.3软件进行Meta分析。结果:共纳入13篇文献,总计814例患者,其中行腹腔镜下保留脾脏的胰体尾切除术399例,行腹腔镜下胰体尾联合脾脏切除术415例。Meta分析结果显示,腹腔镜下保留脾脏的胰体尾切除术患者的手术时间(SMD=-0.79,95%CI=-1.55~-0.03,P=0.04)、术中失血量(SMD=-1.00,95%CI=-1.76~-0.24,P=0.01)及住院时间(SMD=-0.77,95%CI=-1.34~-0.21,P=0.008)均明显少于腹腔镜下胰体尾联合脾脏切除术患者;两组患者术后并发症发生率(OR=0.83,95%CI=0.63~1.10,P=0.19)及再次手术治疗率(OR=1.54,95%CI=0.52~4.59,P=0.44)差异均无统计学意义。结论:腹腔镜下保脾胰体尾切除术治疗胰体尾部肿瘤有较好的临床疗效,不会增加术后并发症发生率。
[Abstract]:Objective: to evaluate the clinical effect of splenic-preserving pancreatectomy under laparoscope in the treatment of pancreatic body-tail tumor. Methods: several domestic and foreign literature databases were searched. According to the exclusion criteria, the documents that met the requirements were selected, the data were extracted and evaluated, and the Meta analysis was carried out with RevMan 5.3 software. Results: a total of 814 patients were included in 13 articles, including 399 cases of splenic body and tail resection and 415 cases of combined splenectomy under laparoscope. The results of Meta analysis showed that: 1. Operative time (SMD=-0.79,95%CI=-1.55~-0.03,P=0.04) and intraoperative blood loss (SMD=-1.00,95%CI=-1.76~-0.24,) in patients undergoing splenomegaly reserved pancreatectomy under laparoscope P0.01) and hospitalization time (SMD=-0.77,95%CI=-1.34~-0.21,P=0.008) were significantly less than those of patients undergoing laparoscopic pancreaticococcynotomy combined with splenectomy. There was no significant difference in the incidence of postoperative complications (OR=0.83,95%CI=0.63~1.10,P=0.19) and reoperation rate (OR=1.54,95%CI=0.52~4.59,P=0.44) between the two groups. Conclusion: laparoscopic splenopancreatectomy is effective in the treatment of pancreatic body and tail tumors without increasing the incidence of postoperative complications.
【作者单位】：兰州大学第二医院普通外科;甘肃省康复中心医院神经康复科;
【基金】：国家自然科学基金资助项目(31670847)
【分类号】：R735.9

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