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腹腔镜手术与开腹手术对结直肠癌患者长期生活质量影响的荟萃分析。

Meta-analysis of the effect of laparoscopic surgery and open surgery on long-term quality of life in patients with colorectal cancer.

机构信息

Shanghai University of Traditional Chinese Medicine, Shanghai, China.

出版信息

Medicine (Baltimore). 2023 Sep 8;102(36):e34922. doi: 10.1097/MD.0000000000034922.

Abstract

OBJECTIVE

To compare the effect of laparoscopic surgery and open surgery on the quality of life of patients with colorectal cancer (CRC) in the growth period after the operation, and to provide a reference for surgical treatment decisions of patients with CRC.

METHODS

PubMed/MEDLINE, EMBASE, Web of Science, and Cochrane databases were searched through May 7, 2022 for clinical studies comparing the postoperative quality of life in CRC patients who underwent laparoscopic surgery with those who underwent open surgery. Data were extracted from eligible studies following rigorous quality review. All studies included patient numbers, surgery type, follow-up length, and quality of life scores.

RESULTS

A total of 6 studies were included, resulting in significantly better physical functioning scores with laparoscopic versus open surgery. (Standardized mean difference = 0.45; 95% CI (0.15, 0.75), P = .003). However, in general health, social functioning, bodily pain, vitality, quality of life index, Global Quality Scale, physical component summary and mental component summary, there was no telling difference between the 2 surgical therapies.

CONCLUSION

Compared with open surgery, laparoscopic surgery has weak advantages. There was no noteworthy difference in the long-term quality of life between the 2 surgical treatments for CRC patients. Whether laparoscopic surgery can bring more improvement to the quality of life of patients with CRC needs more high-quality clinical randomized studies to verify.

摘要

目的

比较腹腔镜手术与开腹手术对生长发育期结直肠癌(CRC)患者术后生活质量的影响,为 CRC 患者的手术治疗决策提供参考。

方法

检索 PubMed/MEDLINE、EMBASE、Web of Science 和 Cochrane 数据库,截至 2022 年 5 月 7 日,纳入比较腹腔镜手术与开腹手术治疗 CRC 患者术后生活质量的临床研究。严格质量评价后提取纳入研究的数据。所有研究均包括患者数量、手术类型、随访时间和生活质量评分。

结果

共纳入 6 项研究,腹腔镜组患者的身体功能评分明显优于开腹组。(标准化均数差=0.45;95%CI(0.15,0.75),P=0.003)。然而,在一般健康、社会功能、躯体疼痛、活力、生活质量指数、全球质量量表、生理成分综合评分和心理成分综合评分方面,两种手术治疗方法之间没有差异。

结论

与开腹手术相比,腹腔镜手术具有微弱优势。两种手术治疗 CRC 患者的长期生活质量无显著差异。腹腔镜手术是否能给 CRC 患者的生活质量带来更多改善,需要更多高质量的临床随机研究来验证。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/b285/10489332/6a0d73547cfb/medi-102-e34922-g001.jpg

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