摘要
目的采用Meta分析比较经腹腔与经腹膜后途径行腹腔镜下肾部分切除术治疗肾肿瘤的疗效与安全性。方法检索各大数据库相关文献,由两名独立文献分析员进行质量评价及数据提取,利用Revman 5.3软件进行分析。结果纳入文献15篇,共计病例1106例。与经腹腔途径相比,经腹膜后途径行腹腔镜下肾部分切除术具有更短的手术时间(SMD=0.45,95%CI:0.05~0.85,P=0.03)、住院时间(SMD=0.66,95%CI:0.44~0.88,P<0.00001)和术后进食时间(SMD=1.74,95%C1:1.33~2.14,P<0.00001),而两者在平均估计出血量(SMD=0.11,95%CI:-0.16~0.38,P=0.41)、平均热缺血时间(SMD=0.26,95%CI:-0.19~0.71,p=0.26)、术后并发症(SMD=0.96,95%CI:0.66~1.39,P=0.83)和切缘阳性(SMD=1.75,95%CI:0.70~4.39,P=0.23)方面效果相当。结论经腹膜后途径行腹腔镜下肾部分切除术具有和经腹腔途径相当的疗效和安全性,其手术时间、术后住院时间和进食时间更短。
Objective To compare the efficacy and safety of retroperitoneal laparoscopic and retroperitoneal laparoscopic partial nephrectomy.Methods We seached sevral databases to identify related studies.Two independent boffins were employed to carry out the quality evaluation and data ex-traction of the studies.RevMan 5.3 software were used to process statistical analysis.Results Final-ly,15 studies were included with 1106 cases.Compared with retroperitoneal laparoscopic,transperito-neal laparoscopic partial nephrectomy had a less operating time(SMD=0.45,95%CI:0.05-0.85,P=0.03),less hospital stay(SMD=0.66,95%CI:0.44-0.88,P<0.00001)and less postoperative feed-ing time(SMD=1.74,95%CI:1.33-2.14,P<0.00001).However,there were no differences be-tween transperitoneal laparoscopic and retroperitoneal laparoscopic partial nephrectomy in estimated blood loss(SMD=0.11,95%CI:-0.16-0.38,P=0.41),warm ischaemia time(SMD=0.26,95%CI:-0.19-0.71,P=0.26),overall postoperative complication rate(SMD=0.96,95%CI:0.66-1.39,P=0.83)and positive margin rate(SMD=1.75,95%CI:0.704.39,P=0.23).Conclu-sions Compared with transperitoneal laparoscopic partial nephrectomy,retroperitoneal laparoscopic partial nephrectomy have a less operating time,less hospital stay and less postoperative feeding time.And retroperitoneal laparoscopic partial nephrectomy have the same efficacy and safety with transperito-neal laparoscopic partial nephrectomy.
作者
范宁
张丽秀
侯子珍
岳中瑾
王志平
尚攀峰
Fan Ning;Zhang Lixiu;Hou Zizhen;Yue Zhongjin;Wang Zhiping;Shang Panfeng(Department of Urology,the Second Hospital of Lanzhou University,Lanzhou 730030,China;Department of Clinical Laboratory Center,Gansu Provincal Maternity and Child-Care Hospital,Lanzhou 730050,China)
出处
《国际泌尿系统杂志》
2021年第3期426-431,共6页
International Journal of Urology and Nephrology
基金
甘肃省卫生行业科研计划项目(GSWSKY2016-11)。
