Ping Li, Fang Fang, Jia-Xun Cai, Dong Tang, Qing-Guo Li, Dao-Rong Wang, Department of Gastrointestinal Surgery, Subei People's Hospital of Jiangsu Province, the First Affiliated Hospital of Yang Zhou University, Yangzhou 225001, Jiangsu Province, China.
World J Gastroenterol. 2013 Dec 21;19(47):9119-26. doi: 10.3748/wjg.v19.i47.9119.
To evaluate the fast-track rehabilitation protocol and laparoscopic surgery (LFT) vs conventional care strategies and laparoscopic surgery (LCC).
Studies and relevant literature comparing the effects of LFT and LCC for colorectal malignancy were identified in MEDLINE, the Cochrane Central Register of Controlled Trials and EMBASE. The complications and re-admission after approximately 1 mo were assessed.
Six recent randomized controlled trials (RCTs) were included in this meta-analysis, which related to 655 enrolled patients. These studies demonstrated that compared with LCC, LFT has fewer complications and a similar incidence of re-admission after approximately 1 mo. LFT had a pooled RR of 0.60 (95%CI: 0.46-0.79, P < 0.001) compared with a pooled RR of 0.69 (95%CI: 0.34-1.40, P > 0.5) for LCC.
LFT for colorectal malignancy is safe and efficacious. Larger prospective RCTs should be conducted to further compare the efficacy and safety of this approach.
评估快速康复方案联合腹腔镜手术(LFT)与传统护理策略联合腹腔镜手术(LCC)的效果。
在 MEDLINE、Cochrane 对照试验中心注册库和 EMBASE 中检索比较结直肠恶性肿瘤的 LFT 和 LCC 效果的研究和相关文献。评估大约 1 个月后并发症和再入院情况。
本荟萃分析纳入了 6 项近期随机对照试验(RCT),共涉及 655 例入组患者。这些研究表明,与 LCC 相比,LFT 的并发症更少,大约 1 个月后再入院的发生率相似。与 LCC 相比,LFT 的汇总 RR 为 0.60(95%CI:0.46-0.79,P<0.001),而 LCC 的汇总 RR 为 0.69(95%CI:0.34-1.40,P>0.5)。
LFT 治疗结直肠恶性肿瘤是安全有效的。应开展更大规模的前瞻性 RCT 进一步比较这种方法的疗效和安全性。