摘要
目的:系统评价国内经脐单孔腹腔镜阑尾切除术(single port laparoscopy appendectomy,SILA)的有效性和安全性.方法:在英文数据库(Pub Med、EMBASE、Cochrane)和中文数据库(CBM、CNKI、VIP和万方)系统检索有关国内SILA与传统腹腔镜阑尾切除术(conventional laparoscopic appendectomy,CLA)的随机对照试验(randomized controlled trials,RCT).按照纳入和排除标准,筛选符合标准的文献后,进行方法学质量评价并提取相关结局数据,使用Rev Man 5.3软件进行分析.结果:最终纳入9项RCT,共878例患者.与CLA相比较,SILA显著增加了手术时间,缩短了胃肠道功能恢复时间,而术后住院时间和术中失血量方面无明显差异.在总的并发症方面、切口感染、肠梗阻和脓肿方面亦均无明显差异,而中转开腹/增加戳口发生率明显高于CLA.结论:国内SILA应用于阑尾切除术是安全有效的,但其经济效应尚不明确.因为存在较高的中转三孔和开腹率,因此对于病情复杂者应做好充分的准备.
AIM： To systematically evaluate the efficacy and safety of transumbilical single-port laparoscopic appendectomy （SILA） in China. METHODS： Online databases （Cochrane Library, PubMed, EMBASE, CBM, CNKI, VIP and Wangfang） were searched for randomized controlled trials （RCTs） investigating therapeutic effects of SILA vs conventional laparoscopic appendectomy （CLA） in China. Methodological quality was assessed, and outcomes were analyzed with Revman 5.3. RESULTS： Nine RCTs containing 878 patients were included. Compared with CLA, SILA significantly increased operation time, but reduced the time to gastrointestinal function recovery. There was no significant difference with regards to postoperative hospital stay and intra-operative blood loss between the two groups. The rate of total complications including wound infection, intestinal obstruction and abscess was similar, although SILA was associated with a higher rate of conversion to open surgery or the use of additional trocars. CONCLUSION： SILA is a safe procedure for laparoscopic appendectomy in China; however, it is associated with a high rate of conversion to laparotomy or three-port laparoscopic appendectomy in serious patients.
出处
《世界华人消化杂志》
CAS
2015年第25期4112-4118,共7页
World Chinese Journal of Digestology
