Huang Kun, Zhong Jie, Jiang Dequan
Department of General Surgery, Central Hospital of Jiangjin District, Chongqing 400000, China.
Department of General Surgery, Chongqing University Jiangjin Hospital, School of Medicine, Chongqing University, Chongqing 40000, China.
J Healthc Eng. 2022 Jun 18;2022:3255403. doi: 10.1155/2022/3255403. eCollection 2022.
To evaluate the efficacy of laparoscopy and laparotomy after neoadjuvant chemotherapy in the treatment of advanced gastric cancer by meta-analysis.
Cochrane Library, Embase, and PubMed were searched by computer until December 1, 2021. Literature was screened according to inclusion and exclusion criteria, and relevant data were extracted for meta-analysis using RevMan 5.3.
A total of 1027 patients from 11 literature studies were included in this study, including 413 patients in the laparoscopic group and 614 patients in the open group. Meta-analysis showed that the laparoscopic group had less intraoperative bleeding (SMD = -1.11; 95% CI: -1.75-0.47; =0.0006), early postoperative exhaust (SMD = -0.45; 95% CI: -0.70-0.20; =0.0004), and shorter postoperative hospital stay (SMD = 0.97; 95% CI: 1.69∼0.26; =0.008), but had longer the operation time (SMD = 0.65; 95% CI: 0.52∼0.79; < 0.00001). There was no significant difference in the number of lymph nodes dissected during operation (SMD = -0.45; 95% CI: -0.42-0.19; =0.45), the incidence of surgical complications 30 days after operation (OR = 0.78; 95% CI: 0.53∼1.13; =0.19), time of first defecation (MD = 0.00; 95% CI: -0.10∼0.10; =0.98), and time of first postoperative feeding (MD = -0.05; 95% CI: -0.22∼0.12; =0.54) between the two groups. For long-term prognosis, there was no significant difference in the 3-year overall survival rate after operation between the two groups (RR = 0.84; 95% CI: 0.63-1.12; =0.23).
Compared with the open stomach cancer surgery, laparoscopic gastric cancer surgery has less intraoperative blood loss, shorter hospitalization time, and advantages such as early rehabilitation, postoperative complications rate, and long-term survival, which confirmed the validity and security of the laparoscopic surgery.
通过Meta分析评价新辅助化疗后腹腔镜手术与开腹手术治疗进展期胃癌的疗效。
通过计算机检索Cochrane图书馆、Embase和PubMed至2021年12月1日。根据纳入和排除标准筛选文献，使用RevMan 5.3提取相关数据进行Meta分析。
本研究共纳入11篇文献研究的1027例患者，其中腹腔镜组413例，开腹组614例。Meta分析显示，腹腔镜组术中出血少（标准化均数差[SMD]=-1.11；95%可信区间[CI]：-1.75-0.47；P=0.0006）、术后排气早（SMD=-0.45；95%CI：-0.70-0.20；P=0.0004）、术后住院时间短（SMD=-0.97；95%CI：-1.69-0.26；P=0.008），但手术时间长（SMD=0.65；95%CI：0.520.79；P<0.00001）。两组术中清扫淋巴结数量（SMD=-0.45；95%CI：-0.420.19；P=0.45）、术后30天手术并发症发生率（比值比[OR]=0.78；95%CI：0.531.13；P=0.19）、首次排便时间（平均差[MD]=0.00；95%CI：-0.100.10；P=0.98）及术后首次进食时间（MD=-0.05；95%CI：-0.220.12；P=0.54）比较，差异均无统计学意义。对于长期预后，两组术后3年总生存率比较，差异无统计学意义（风险比[RR]=0.84；95%CI：0.63~1.12；P=0.23）。
与开腹胃癌手术相比，腹腔镜胃癌手术具有术中失血少、住院时间短、术后康复早等优点，在术后并发症发生率及长期生存方面相当，证实了腹腔镜手术的有效性和安全性。
