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目的:荟萃分析单孔腹腔镜及传统腹腔镜腹膜外无张力修补术的安全性及可行性。方法:检索1989-2014中国期刊全文数据库(CNKI)、维普中文期刊数据库、PubMed、The Cochrane Library以及EMBASE等数据库中,对单孔腹腔镜及传统腹腔镜腹膜外无张力修补术进行荟萃分析,按照纳入与排除标准选择试验、提取资料后,采用RevMan 5.2软件进行Meta分析,以P<0.05为差异有统计学意义。结果:共10例研究纳入研究,单孔腹腔镜手术526人,传统腹腔镜手术462人,meta分析提示单孔腹腔镜单侧/双侧手术时间虽然明显长于传统腹腔镜腹膜外无张力修补术(WMD=7.72和9.66,P<0.05),但是两组患者术后并发症、术后发生血肿、术后复发、术后住院时间差异没有统计学意义,两者安全性相当。结论:单孔腹腔镜下疝修补手术的围手术期安全性与传统腹腔镜腹膜外无张力修补术相比没有明显差异,在患者美观要求较高,且符合微创手术指征时可行单孔腹腔镜手术。但进一步结论亟待进一步大样本RCT研究证实。
Abstract：Objective: To compare the outcomes by single-port and conventional laparoscopic total extraperitoneal herniorrhaphy( TEP). Methods: Literatures published between 1989 and 2014 were searched in databases of China National Knowledge Infrastructure( CNKI),VIP Chinese journals,PubMed,Cochrane Library and EMBASE. A meta-analysis was performed on TEP through single-port vs multi-port laparoscopy. The retrieved studies were subjected to a set of inclusion and exclusion criteria. Then the data were extracted data using RevMan 5. 2 software. A P < 0. 05 was considered statistically significant. Results: A total of 10 studies were included in this meta-analysis,involving 526 cases of single port laparoscopic TEP and 462 cases of conventional laparoscopic TEP. Meta-analysis showed that,although single port laparoscopic TEP for unilateral or bilateral lesions needed significantly longer operative time than did the conventional laparoscopic TEP( WMD =7. 72 and 9. 66,P < 0. 05),the two options did not differ in postoperative complications,hematoma,recurrence and hospital stay after surgery. The both options were as equally safe. Conclusion: Single-port laparoscopic TEP does not differ significantly from conventional laparoscopic TEP in perioperative safety. For patients with aesthetic requirements and indications for minimally invasive surgery,single-port TEP may be considered. However,RCTs with larger sample size are needed for further validation of our findings.
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基本信息:
中图分类号:R656.21
引用信息:
[1]李铮宇,谭淑云,黄美近.基于对照试验的单孔与多孔腹腔镜疝修补术系统评价研究[J].广州医科大学学报,2016,44(03):15-20.
2016-06-15
2016-06-15