Jien He, Xiaohua Li
Department of Surgical Oncology.
Department of Radiotherapy, Baoji Central Hospital, China.
Medicine (Baltimore). 2021 Feb 26;100(8):e24155. doi: 10.1097/MD.0000000000024155.
The aim of this study was to systematically evaluate and compare the effectiveness and safety of laparoscopic versus open resection (LR vs OR) in the treatment of hepatic hemangioma.
We searched PubMed, the Cochrane Library, Web of Science, Medline, EMBASE, and the Chinese Biomedicine Database from January 2000 to April 2020 for studies comparing the outcomes of laparoscopic versus open surgery in hepatic hemangioma treatment.
Based on the preset criteria, 12 randomized clinical trials (RCTs) and 12 observational clinical studies (OCSs) were selected for analysis. Our results showed that laparoscopic surgery was more effective than open surgery in terms of reducing operation time, intraoperative blood loss, postoperative exhaust time, postoperative complications, postoperative bile leak, postoperative intra-abdominal infection, postoperative alanine aminotransferase (ALT) and aspartate aminotransferase (AST) values, postoperative visual analog scale (VAS) scores, and hospitalize length. No significant differences were found between the 2 groups in hepatectomy time, hospitalized cost, intra-abdominal hemorrhage, and the postoperative recurrence of hemangioma.
While similar therapeutic effect was achieved by the compared herein surgical methods, the findings of our analysis revealed that laparoscopic surgery is superior over open surgery in terms of less trauma, faster recovery, less postoperative pain, shorter hospitalize length, and reduced postoperative complications. Therefore, laparoscopic resection of hepatic hemangioma is a safe, effective, and feasible surgical method that is worth considering in clinical applications.
本研究旨在系统评价和比较腹腔镜切除术与开放切除术(LR 与 OR)治疗肝血管瘤的有效性和安全性。
我们检索了 2000 年 1 月至 2020 年 4 月期间的 PubMed、Cochrane 图书馆、Web of Science、Medline、EMBASE 和中国生物医学数据库,以查找比较腹腔镜手术与开放手术治疗肝血管瘤疗效的研究。
根据预设标准,选择 12 项随机临床试验(RCT)和 12 项观察性临床研究(OCS)进行分析。我们的结果表明,在减少手术时间、术中出血量、术后排气时间、术后并发症、术后胆漏、术后腹腔内感染、术后丙氨酸氨基转移酶(ALT)和天冬氨酸氨基转移酶(AST)值、术后视觉模拟评分(VAS)以及住院时间方面,腹腔镜手术比开放手术更有效。两组在肝切除时间、住院费用、腹腔内出血和血管瘤术后复发方面无显著差异。
虽然本文比较的手术方法取得了相似的治疗效果,但我们的分析结果显示,腹腔镜手术在创伤小、恢复快、术后疼痛轻、住院时间短和术后并发症少方面优于开放手术。因此,腹腔镜肝血管瘤切除术是一种安全、有效且可行的手术方法,值得在临床应用中考虑。