Wang Ya-Ru, Lu Hui-Fang, Huo Hui-Can, Qu Chang-Ping, Sun Gui-Xia, Shao Shi-Qing
Medicine (Baltimore). 2018 Apr;97(17):e0474. doi: 10.1097/MD.0000000000010474.
The endometrial carcinoma (EC) is the most frequently occurring female genital cancer. The authors performed this network meta-analysis to compare operative time and the incidence of bowel injury and wound infection of 3 operative approaches (laparoscopy, laparotomy, and laparoscopic-assisted vaginal hysterectomy [LAVH]) in the treatment of EC.
The Cochrane Library, PubMed, and Embase databases were searched. Randomized controlled trials (RCTs) for EC from the day of databases establishment to February 2017 were included. Direct and indirect evidences were combined to calculate the combined weighted mean difference (WMD) or odd ratio values and the surface under the cumulative ranking curve (SUCRA) value of 3 operative approaches in the treatment of EC.
A total of 9 qualified RCTs were included into the study. The results showed that laparotomy had a shorter-operative time than LAVH (WMD = -40.36, 95% confidence interval = -75.03 to -2.57). However, there was no significant difference in the incidence of bowel injury and wound infection among 3 operative approaches. Besides, the SUCRA values indicated that laparotomy had the shortest operative time but the incidence of bowel injury and wound infection was relatively higher.
The results from this study indicate that laparotomy had highest incidence of bowel injury and wound infection but shortest operative time among 3 operative approaches in the treatment of EC.
子宫内膜癌（EC）是最常见的女性生殖系统癌症。作者进行了这项网状Meta分析，以比较3种手术方式（腹腔镜手术、开腹手术和腹腔镜辅助阴式子宫切除术[LAVH]）治疗EC时的手术时间、肠损伤发生率和伤口感染发生率。
检索Cochrane图书馆、PubMed和Embase数据库。纳入自建库之日至2017年2月的EC随机对照试验（RCT）。合并直接和间接证据，计算3种手术方式治疗EC的合并加权均数差（WMD）或比值比以及累积排序曲线下面积（SUCRA）值。
共纳入9项合格的RCT。结果显示，开腹手术的手术时间比LAVH短（WMD = -40.36，95%置信区间 = -75.03至-2.57）。然而，3种手术方式的肠损伤发生率和伤口感染发生率无显著差异。此外，SUCRA值表明，开腹手术的手术时间最短，但肠损伤发生率和伤口感染发生率相对较高。
本研究结果表明，在治疗EC的3种手术方式中，开腹手术的肠损伤发生率和伤口感染发生率最高，但手术时间最短。
