Department of Gynecology, The Eighth Affiliated Hospital of SUN YAT-SEN University, Shenzhen, Guangdong, China.
Department of Organ Transplantation, The Second Affiliated Hospital of Guangzhou University of Chinese Medicine, Guangzhou, Guangdong, China.
Int Wound J. 2023 Apr;20(4):1061-1071. doi: 10.1111/iwj.13962. Epub 2022 Sep 16.
We performed a meta-analysis to evaluate the effect of minimally invasive surgery and laparotomy on wound infection and postoperative and intraoperative complications in the management of cervical cancer. A systematic literature search up to July 2022 was performed and 10 231 subjects with cervical cancer at the baseline of the studies; 4307 of them were using the minimally invasive surgery, and 5924 were using laparotomy. Odds ratio (OR) with 95% confidence intervals (CIs) were calculated to assess the effect of minimally invasive surgery and laparotomy on wound infection and postoperative and intraoperative complications in the management of cervical cancer using the dichotomous methods with a random or fixed-effect model. The minimally invasive surgery had significantly lower wound infection (OR, 0.20; 95% CI, 0.13-0.30, P < .001), and postoperative complications (OR, 0.48; 95% CI, 0.37-0.64, P < .001) in subjects with cervical cancer compared laparotomy. However, minimally invasive surgery compared with laparotomy in subjects with cervical cancer had no significant difference in intraoperative complications (OR, 1.04; 95% CI, 0.80-1.36, P = 0.76). The minimally invasive surgery had significantly lower wound infection, and postoperative complications however, had no significant difference in intraoperative complications in subjects with cervical cancer compared with laparotomy. The analysis of outcomes should be with caution because of the low sample size of 22 out of 41 studies in the meta-analysis and a low number of studies in certain comparisons.
我们进行了一项荟萃分析,以评估微创外科和剖腹手术对宫颈癌管理中伤口感染以及术后和术中并发症的影响。系统检索截至 2022 年 7 月的文献,共有 10231 名宫颈癌患者纳入研究的基线;其中 4307 名患者接受微创外科治疗,5924 名患者接受剖腹手术。采用二项分类方法,随机或固定效应模型计算比值比(OR)及其 95%置信区间(CI),以评估微创外科和剖腹手术对宫颈癌管理中伤口感染以及术后和术中并发症的影响。与剖腹手术相比,微创外科治疗宫颈癌患者的伤口感染(OR,0.20;95%CI,0.13-0.30,P<0.001)和术后并发症(OR,0.48;95%CI,0.37-0.64,P<0.001)明显更低。然而,与剖腹手术相比,微创外科治疗宫颈癌患者的术中并发症无显著差异(OR,1.04;95%CI,0.80-1.36,P=0.76)。与剖腹手术相比,微创外科治疗宫颈癌患者的伤口感染和术后并发症明显更低,但术中并发症无显著差异。由于荟萃分析中 41 项研究中有 22 项研究的样本量较小,某些比较的研究数量较少,因此分析结果应谨慎对待。