胸腔镜-腹腔镜联合食管癌切除术与开放食管癌切除术的比较：一项荟萃分析。

The comparison of thoracoscopic-laparoscopic esophagectomy and open esophagectomy: A meta-analysis.

作者信息

Wang B, Zuo Z, Chen H, Qiu B, Du M, Gao Y

机构信息

Department of Thoracic Surgical Oncology, National Cancer Center/Cancer Hospital, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Thoracic Cancer Treatment Center, Armed Police Beijing Corps Hospital, Beijing, China.

出版信息

Indian J Cancer. 2017 Jan-Mar;54(1):115-119. doi: 10.4103/ijc.IJC_192_17.

DOI:10.4103/ijc.IJC_192_17

PMID:29199673

Abstract

OBJECTIVE

The objective of this study was to perform a meta-analysis to evaluate the effects of thoracoscopic-laparoscopic esophagectomy (TLE) and open esophagectomy (OE) in the treatment of esophageal cancer.

METHODS

A literature search was performed using PubMed, Embase, and Google Scholar databases for relevant keywords and the medical subject headings. After we had screened further, 13 clinical trials were included in the final meta-analysis. Specific odds ratios (ORs), standardized mean differences (SMDs), mean differences (MDs), and confidence intervals (CIs) were calculated.

RESULTS

The outcomes of treatment effects included anastomotic leakage, blood loss, number of lymph nodes harvested, and operating time. Comparing OE for esophageal cancer patients, the pooled OR of anastomotic leakage was 0.89 (95% CI = [0.47, 1.68]), the pooled SMD of blood loss was - 0.56 (95% CI = [-0.77, -0.35]), the pooled MD of lymph nodes harvested was - 0.93 (95% CI = [-2.35, 0.50]), and the pooled SMD of operating time was 0.31 (95% CI = [0.02, 0.59]).

CONCLUSION

TLE was found to significantly decrease patients' blood loss. There is no difference of anastomotic leakage and the number of lymph nodes harvested between TLE and OE.

摘要

目的

本研究的目的是进行一项荟萃分析，以评估胸腔镜-腹腔镜联合食管癌切除术（TLE）和开放食管癌切除术（OE）治疗食管癌的效果。

方法

使用PubMed、Embase和谷歌学术数据库，通过相关关键词和医学主题词进行文献检索。进一步筛选后，最终的荟萃分析纳入了13项临床试验。计算了特定的比值比（OR）、标准化均数差（SMD）、均数差（MD）和置信区间（CI）。

结果

治疗效果的结果包括吻合口漏、失血量、收获的淋巴结数量和手术时间。与OE治疗食管癌患者相比，吻合口漏的合并OR为0.89（95%CI = [0.47, 1.68]），失血量的合并SMD为-0.56（95%CI = [-0.77, -0.35]），收获的淋巴结数量的合并MD为-0.93（95%CI = [-2.35, 0.50]），手术时间的合并SMD为0.31（95%CI = [0.02, 0.59]）。