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微创与开腹手术治疗肝细胞癌患者肝切除术后伤口并发症的效果:Meta 分析。

Effect of minimally invasive versus open surgery in hepatectomy on postoperative wound complications in patients with hepatocellular carcinoma: A meta-analysis.

机构信息

Department of Anesthesiology, The Sixth Medical Center of PLA General Hospital, Beijing, China.

Department of Anesthesiology, Hainan Branch of General Hospital of People's Liberation Army, Sanya, China.

出版信息

Int Wound J. 2023 Dec;20(10):4159-4165. doi: 10.1111/iwj.14313. Epub 2023 Jul 13.

Abstract

In a meta-analysis, we assessed the impact of different surgical approaches on the outcome of hepatectomy with hepatocellular carcinoma. Four databases, including PubMed, Embase, Cochrane Library, and the Web of Science, have been critically reviewed through the full literature through June 2023. Eleven related trials were examined once they had met the trial's classification and exclusion criteria, as well as the assessment of the quality. A random effects approach was applied to analysis of operative organ infections, and a fixed-effect model was applied to determine the 95% CI and OR. Analysis of the data was done with RevMan 5.3. Our findings indicated that patients undergoing minimally invasive liver cancer surgery had significantly lower risks of surgical organ infection (OR, 0.35; 95% CI, 0.16-0.77; p = 0.009) and wound infection (OR, 0.19; 95% CI, 0.13-0.28; p < 0.001) compared to those undergoing open surgery. There was no heterogeneity observed between the two groups (I  = 0) in wound infection. Nevertheless, because of the limited number of randomised controlled trials in this meta-analysis, care should be taken and carefully considered in the treatment of these values. Further high-quality studies involving a large number of samples are needed to validate and reinforce the results.

摘要

在一项荟萃分析中,我们评估了不同手术入路对肝细胞癌肝切除术结果的影响。通过全面检索PubMed、Embase、Cochrane 图书馆和 Web of Science 这四个数据库,我们对截至 2023 年 6 月的所有文献进行了严格评价。当符合试验分类和排除标准以及质量评估标准时,我们会对 11 项相关试验进行检查。我们采用随机效应方法分析手术器官感染,采用固定效应模型确定 95%CI 和 OR。使用 RevMan 5.3 对数据进行分析。我们的研究结果表明,与开放性手术相比,接受微创肝癌手术的患者手术器官感染(OR,0.35;95%CI,0.16-0.77;p=0.009)和伤口感染(OR,0.19;95%CI,0.13-0.28;p<0.001)的风险显著降低。两组之间在伤口感染方面没有观察到异质性(I²=0)。然而,由于这项荟萃分析中随机对照试验的数量有限,在治疗这些数值时应谨慎并仔细考虑。需要进一步开展高质量、大样本的研究来验证和加强这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e64d/10681463/d110addf8e48/IWJ-20-4159-g006.jpg

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