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三维与二维视频辅助肝切除术治疗肝脏疾病:临床数据的荟萃分析

Three-dimensional versus two-dimensional video-assisted hepatectomy for liver disease: a meta-analysis of clinical data.

作者信息

Zhang Shumao, Huang Zhanwen, Cai Liang, Zhang Wei, Ding Haoyuan, Zhang Li, Chen Yue

机构信息

Department of Nuclear Medicine, Affiliated Hospital, Southwest Medical University, Luzhou, China.

Nuclear Medicine and Molecular Imaging Key Laboratory of Sichuan Province, Sichuan, China.

出版信息

Wideochir Inne Tech Maloinwazyjne. 2021 Mar;16(1):1-9. doi: 10.5114/wiitm.2020.100678. Epub 2020 Nov 5.

Abstract

INTRODUCTION

The benefit of three-dimensional (3D) visualization for liver disease is uncertain.

AIM

To evaluate the effectiveness and safety of 3D versus two-dimensional (2D) video-assisted hepatectomy for LD.

MATERIAL AND METHODS

We searched PubMed, Embase, Cochrane Library, Medline, and Web of Science for studies addressing 3D versus 2D for 2D until 30 February 2020. Study-specific effect sizes and their 95% confidence intervals (CIs) were combined to calculate the pooled value using a fixed-effects or random-effects model.

RESULTS

Nine studies with 808 patients were included. The 3D group had shorter operative time (mean difference (MD) = 34.39; 95% CI = 59.50, 9.28), experienced less intraoperative blood loss (MD = 106.55; 95% CI = 183.76, 29.34), and a smaller blood transfusion volume (MD = 88.25; 95% CI = 141.26, 35.24). The 3D group had a smaller difference between the predicted volume and the actual resected volume (MD = 103.25; 95% CI = 173.24, 33.26) and a lower rate of postoperative complications (odds ratio (OR) = 0.57; 95% CI: 0.35, 0.91).

CONCLUSIONS

During surgery, 3D video-assisted hepatectomy could effectively reduce operative time, intraoperative bleeding, and blood transfusion volume, and had a smaller difference between the predicted volume and the actual resected volume and a lower rate of postoperative complications. More high-quality randomized controlled trials are required to verify the reliability and validity of our conclusion.

摘要

引言

三维(3D)可视化技术对肝脏疾病的益处尚不确定。

目的

评估3D与二维(2D)视频辅助肝切除术治疗肝脏疾病的有效性和安全性。

材料与方法

我们检索了PubMed、Embase、Cochrane图书馆、Medline和科学网,以查找截至2020年2月29日比较3D与2D用于肝脏疾病的研究。使用固定效应或随机效应模型合并研究特异性效应量及其95%置信区间(CI)以计算合并值。

结果

纳入9项研究,共808例患者。3D组手术时间较短(平均差(MD)= 34.39;95%CI = 59.50,9.28),术中出血量较少(MD = 106.55;95%CI = 183.76,29.34),输血量较小(MD = 88.25;95%CI = 141.26,35.24)。3D组预测体积与实际切除体积之间的差异较小(MD = 103.25;95%CI = 173.24,33.26),术后并发症发生率较低(比值比(OR)= 0.57;95%CI:0.35,0.91)。

结论

在手术过程中,3D视频辅助肝切除术可有效缩短手术时间、减少术中出血和输血量,预测体积与实际切除体积之间的差异较小,术后并发症发生率较低。需要更多高质量的随机对照试验来验证我们结论的可靠性和有效性。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/baec/7991933/66dbbbae2441/WIITM-16-42364-g001.jpg

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