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腹腔镜与开腹食管胃去血管化联合脾切除术治疗门静脉高压症的比较:一项荟萃分析。

Comparison of laparoscopic verse open oesophagogastric devascularisation with splenectomy in portal hypertension: A meta-analysis.

作者信息

Zhang Hu

机构信息

Department of General Surgery, Xintai City People's Hospital, Xintai, Shandong Province, China.

出版信息

J Minim Access Surg. 2025 Jul 1;21(3):223-230. doi: 10.4103/jmas.jmas_362_23. Epub 2025 Jul 14.

Abstract

To assess the efficacy and safety in treating portal hypertension by laparoscopic oesophagogastric devascularisation with splenectomy. I searched the randomised controlled trials about the efficacy and safety of laparoscopic oesophagogastric devascularisation with splenectomy in treating portal hypertension from PubMed (19982023.02), Wanfang Data (19902023.02), China National Knowledge Infrastructure (19792023.02), Whip (19892023.02) and International Statistical Institute (1998~2023.02). I extracted the data from these trials, and I got the meta-analysis from RevMan 5.3 software. Seventeen randomised control trials involving 1326 patients were included (671 patients in the laparoscopic oesophagogastric devascularisation with splenectomy in the portal hypertension group and 655 patients in the open resection group). Compared with open resection group, this Meta-analysis showed that laparoscopic esophagogastric devascularization with splenectomy in portal hypertension group could reduce the intraoperative bloodloss (P < 0.05), shorten the postoperative time of recovery of intestinal peristalsis (P < 0.05), reduce the postoperative drainage volume (P < 0.05), reduce the drainage tube removal time (P < 0.05), shorten the postoperation hospital stay (P < 0.05), shorten the total hospitalization cost (P = 0.05), shorten the postoperative ambulation (P < 0.05), shorten the postoperative complication rate (P < 0.05). But there was no significant difference in the operation time (P > 0.05). However, there was no significant difference in the operation time (P > 0.05). Compared with open resection group, the total effect of laparoscopic oesophagogastric devascularisation with splenectomy in the treatment of portal hypertension is better. Laparoscopic oesophagogastric devascularisation with splenectomy in the treatment of portal hypertension is acceptable.

摘要

评估腹腔镜食管胃去血管化联合脾切除术治疗门静脉高压症的疗效和安全性。我检索了PubMed(1998年至2023年2月)、万方数据(1990年至2023年2月)、中国知网(1979年至2023年2月)、维普(1989年至2023年2月)和国际统计学会(1998年至2023年2月)中关于腹腔镜食管胃去血管化联合脾切除术治疗门静脉高压症疗效和安全性的随机对照试验。我从这些试验中提取数据,并使用RevMan 5.3软件进行荟萃分析。纳入了17项随机对照试验,涉及1326例患者(门静脉高压症组671例行腹腔镜食管胃去血管化联合脾切除术,开放切除组655例)。该荟萃分析表明,与开放切除组相比,门静脉高压症组腹腔镜食管胃去血管化联合脾切除术可减少术中出血量(P<0.05),缩短术后肠道蠕动恢复时间(P<0.05),减少术后引流量(P<0.05),缩短引流管拔除时间(P<0.05),缩短术后住院时间(P<0.05),缩短总住院费用(P = 0.05),缩短术后下床活动时间(P<0.05),降低术后并发症发生率(P<0.05)。但手术时间差异无统计学意义(P>0.05)。然而,手术时间差异无统计学意义(P>0.05)。与开放切除组相比,腹腔镜食管胃去血管化联合脾切除术治疗门静脉高压症的总体效果更好。腹腔镜食管胃去血管化联合脾切除术治疗门静脉高压症是可接受的。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c54d/12327776/ebb76009c359/JMAS-21-223-g001.jpg

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