Qiao Qing, Zhou Leting, Hu Kun, Xu Deyu, Li Lin, Lu Guoyuan
a Department of Nephrology , Soochow University , Suzhou , Jiangsu , China.
Ren Fail. 2016 Jun;38(5):838-48. doi: 10.3109/0886022X.2015.1077313. Epub 2016 Mar 4.
The objective of this study is to compare the catheter-related complications as well as catheter survival between laparoscopic and traditional surgery in peritoneal dialysis catheter insertion.
Five randomized controlled trials and 11 cohort studies were identified. Meta-analysis showed laparoscopic catheter is superior to traditional surgery in terms of controlling catheter migration (OR 0.17, 95% CI 0.08-0.33; p < 0.00001) and catheter survival rate (1-year survival rate: OR 3.05, 95% CI 1.72-5.41, p = 0.0001; 2-year survival rate: OR 2. 07, 95% CI 1.29-3.33, p = 0.0001), but slightly increases the risk of bleeding (OR 2.13, 95% CI 1.07-4.23, p = 0.03). The two groups were not significantly different in other catheter-related complications. As regards the quality of the analysis, only the migration analysis ranked A-level, while the rest fell into Class B or C. The overall research quality was moderate.
Laparoscopic surgery is superior to traditional surgery on reducing catheter migration and prolonging catheter survival rate according to our analysis.
本研究旨在比较腹腔镜手术与传统手术在腹膜透析导管插入术中导管相关并发症及导管留存情况。
共纳入5项随机对照试验和11项队列研究。荟萃分析显示，腹腔镜置管在控制导管移位（比值比0.17，95%置信区间0.08 - 0.33；p < 0.00001）和导管留存率方面优于传统手术（1年留存率：比值比3.05，95%置信区间1.72 - 5.41，p = 0.0001；2年留存率：比值比2.07，95%置信区间1.29 - 3.33，p = 0.0001），但出血风险略有增加（比值比2.13，95%置信区间1.07 - 4.23，p = 0.03）。两组在其他导管相关并发症方面无显著差异。在分析质量方面，仅导管移位分析为A级，其余为B级或C级。总体研究质量中等。
根据我们的分析，腹腔镜手术在减少导管移位和提高导管留存率方面优于传统手术。
