腹腔镜手术与开放手术治疗直肠癌的短期和长期结局：一项随机对照试验的系统评价和荟萃分析
Short- and long-term outcomes of laparoscopic versus open surgery for rectal cancer: A systematic review and meta-analysis of randomized controlled trials.
作者信息
Lin Zhong, Jiang Zheng-Li, Chen Dan-Yang, Chen Min-Fang, Chen Li-Hua, Zhou Peng, Xia Ai-Xiao, Zhu Yan-Wu, Jin Hui, Ge Qiang-Qiang
机构信息
Department of Clinical Pharmacy, Taizhou Hospital of Zhejiang Province, Linhai.
Rehabilitation Department, Taizhou Hospital of Zhejiang Province.
出版信息
Medicine (Baltimore). 2018 Dec;97(50):e13704. doi: 10.1097/MD.0000000000013704.
OBJECTIVES
The present meta-analysis aimed to evaluate the short- and long-term outcomes of laparoscopic surgery (LS) versus open surgery (OS) for rectal cancer.
METHODS
PubMed, Web of Science, and Cochrane Library, were searched for eligible randomized controlled trials (RCTs) published up to June 2017. Operation related index, postoperative complication, and long-term survival rate and disease-free survival rate were evaluated by meta-analytical techniques.
RESULT
Nine RCTs enrolling 4126 patients were included in the present meta-analysis. Compared to OS, LS had similar positive circumferential resection margin (CRM) and number of lymph nodes extracted (LNE) as well as long term 5 years survival rate and disease-free survival rate, but of which the risk tendency was higher in LS group. The short-term outcomes of major and total postoperative complication were lower in LS group.
CONCLUSIONS
LS for rectal cancer was as safe and effective as OS in terms of long-term outcomes, but with lower postoperative complication.
目的
本荟萃分析旨在评估腹腔镜手术（LS）与开放手术（OS）治疗直肠癌的短期和长期疗效。
方法
检索PubMed、科学网和考克兰图书馆，查找截至2017年6月发表的符合条件的随机对照试验（RCT）。采用荟萃分析技术评估手术相关指标、术后并发症以及长期生存率和无病生存率。
结果
本荟萃分析纳入了9项随机对照试验，共4126例患者。与开放手术相比，腹腔镜手术的环周切缘阳性（CRM）和提取淋巴结数量（LNE）相似，长期5年生存率和无病生存率也相似，但腹腔镜手术组的风险倾向更高。腹腔镜手术组术后主要和总体并发症的短期疗效较低。
结论
就长期疗效而言，腹腔镜手术治疗直肠癌与开放手术一样安全有效，但术后并发症较少。
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