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抽吸硬化术与腹腔镜去顶术治疗肾囊肿:哪种方法更好?

Aspiration-sclerotherapy versus laparoscopic de-roofing in the treatment of renal cysts: which is better?

机构信息

Department of Urology, West China Hospital, West China Hospital, Sichuan University, No. 37, Guoxue Alley, Chengdu, Sichuan, People's Republic of China.

State Key Laboratory of Biotherapy and Cancer Center, West China Hospital, Sichuan University, Chengdu, 61000, People's Republic of China.

出版信息

BMC Nephrol. 2020 May 24;21(1):193. doi: 10.1186/s12882-020-01832-7.

Abstract

BACKGROUND

To compare the clinical efficiency between aspiration-sclerotherapy (AS) and laparoscopic de-roofing (LD) in the management of renal cysts through meta-analysis of comparative studies.

METHOD

A comprehensive literature search was performed by PubMed, MEDLINE, Ovid and Web of Science for relevant studies published up to January 2020. The statistical analyses were conducted with Review Manager 5.3.0 and Stata 15.1. The sensitivity analysis was also carried out to confirm the reliability of this Meta-analysis.

RESULTS

Our searches of literature generated 6 studies (1547 patients incorporated) comparing AS with LD in the impacts of renal cyst therapy. Of these, 6 studies contained 1106 and 441 patients who were treated with AS and LD, respectively. The outcome of this meta-analysis indicated that LD group was superior in symptomatic successful rate [Odds Ratio (OR): 0.28; 95%Confidence Interval (CI): 0.09 to 0.86; P = 0.03), radiological successful rate (OR: 0.06; 95%CI: 0.02 to 0.15; P < 0.01) and recurrence rate (OR: 6.08; 95%CI: 2.81 to 13.15; p < 0.01). Nevertheless, AS group had shorter treatment time [Mean Difference (MD):-51.10; 95% CI:-73.01 to - 29.20; p < 0.01]. No statistically significant difference was showed in the rate of complications (OR: 3.19; 95% CI: 0.39 to 25.88; P = 0.28).

CONCLUSIONS

In our meta-analysis, LD had higher symptomatic successful rate, radiological successful rate as well as lower recurrence rate than AS, while the treatment time was longer.

摘要

背景

通过对比较研究的荟萃分析,比较抽吸硬化治疗(AS)和腹腔镜去顶术(LD)在治疗肾囊肿中的临床疗效。

方法

通过 PubMed、MEDLINE、Ovid 和 Web of Science 对截至 2020 年 1 月发表的相关研究进行全面文献检索。使用 Review Manager 5.3.0 和 Stata 15.1 进行统计分析。还进行了敏感性分析,以确认这项荟萃分析的可靠性。

结果

我们的文献搜索共生成了 6 项研究(纳入 1547 例患者),比较了 AS 和 LD 在肾囊肿治疗中的影响。其中,6 项研究分别包含 1106 例和 441 例接受 AS 和 LD 治疗的患者。这项荟萃分析的结果表明,LD 组在症状成功率[优势比(OR):0.28;95%置信区间(CI):0.09 至 0.86;P=0.03]、影像学成功率(OR:0.06;95%CI:0.02 至 0.15;P<0.01)和复发率(OR:6.08;95%CI:2.81 至 13.15;p<0.01)方面更优。然而,AS 组的治疗时间更短[平均差(MD):-51.10;95%CI:-73.01 至-29.20;p<0.01]。并发症发生率无统计学差异(OR:3.19;95%CI:0.39 至 25.88;P=0.28)。

结论

在我们的荟萃分析中,LD 组的症状成功率、影像学成功率更高,复发率更低,而治疗时间更长。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/5c5c/7245882/2e9cc43966e5/12882_2020_1832_Fig1_HTML.jpg

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