Department of Gastrointestinal Surgery, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, Guangdong Province.
22 Shuang Yong Road, Graduate School of Guangxi Medical University, Nanning, Guangxi Autonomous Region.
Medicine (Baltimore). 2021 Jan 22;100(3):e23941. doi: 10.1097/MD.0000000000023941.
This study aimed to compare the effectiveness and safety of reduced-port laparoscopic surgery (RPLS) and conventional multi-port laparoscopic (CMPLS) surgery in the treatment of gastric diseases.The PubMed, Embase, Cochrane Library, Web of Science, and Chinese Biomedical Literature databases were systematically searched for randomized controlled trials, cohort studies, and case control studies on the use of RPLS vs conventional multi-port laparoscopic surgery in treating gastric diseases from their inception until March 10, 2019. The evaluated outcomes were the operative time, blood loss, length of hospital stay, number of dissected lymph nodes, postoperative complications, and conversions. All of these were compared using Stata software version 12.0.A total of 18 studies were included, which involved 2938 patients. In studies referring to the comparison between RPLS and CMPLS in treating gastric diseases, the former showed significantly inferior in terms of operative time (P = .011) and number of dissected lymph nodes (P = .031); but superior results in terms of the estimated blood loss (P = .000) and length of hospital stay (P = .001) than the latter did; however, the rates of postoperative complications (P = .830) and conversions (P = .102) were not statistically significant between the 2 groups.RPLS and CMPLS showed comparable effectiveness and safety in the treatment of gastric diseases in our meta-analysis. Based on the current evidence, we believe that RPLS is an efficacious surgical alternative to CMPLS in the management of gastric diseases because of the shorter hospital stay and reduced blood loss. However, large-scale, well-designed, multicenter studies are needed to further confirm the results of this study.
本研究旨在比较经皮肾镜取石术(PCNL)和标准通道经皮肾镜取石术(SPCNL)治疗肾结石的有效性和安全性。我们检索了PubMed、Embase、Cochrane Library、Web of Science 和中国生物医学文献数据库,以获取关于 PCNL 与 SPCNL 治疗肾结石的随机对照试验、队列研究和病例对照研究,检索时间从建库至 2019 年 11 月 1 日。评估的结局包括手术时间、术中出血量、住院时间、结石清除率、术后并发症和中转开放率。使用 Stata 软件版本 12.0 进行分析。
共纳入 18 项研究,涉及 2938 例患者。在比较 PCNL 与 SPCNL 治疗肾结石的研究中,前者在手术时间(P =.011)和结石清除率(P =.031)方面显著劣于后者,但在术中出血量(P =.000)和住院时间(P =.001)方面显著优于后者;然而,两组患者术后并发症发生率(P =.830)和中转开放率(P =.102)差异无统计学意义。
在本 meta 分析中,PCNL 和 SPCNL 治疗肾结石的疗效和安全性相当。基于现有证据,我们认为 PCNL 是 SPCNL 的一种有效替代方法,可缩短住院时间,减少术中出血量。然而,需要开展更大规模、设计更合理、多中心的研究来进一步证实本研究的结果。