| 杨 胜,马 利,熊兵红.腹腔镜与开腹直肠癌术后复发率比较的Meta分析[J].肿瘤学杂志,2013,19(8):616-622. |
| 腹腔镜与开腹直肠癌术后复发率比较的Meta分析 |
| Laparoscopic Versus Open Rectectomy for Rectal Cancer： A Meta-analysis of Results of Randomized Controlled Trials on Recurrence Postoperation |
| 投稿时间：2013-06-25 |
| DOI：10.11735/j.issn.1671-170X.2013.08.B007 |
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| 中文关键词: 直肠肿瘤 腹腔镜手术 复发 荟萃分析 |
| 英文关键词:rectal neoplasms laparoscopy recurrence meta-analysis |
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| 中文摘要: |
| 摘 要：［目的］ 评价腹腔镜与开腹直肠癌手术术后复发率的长期肿瘤学效果。［方法］ 系统检索Medline、Embase、Cochrane中1991年1月至2012年10月间发表的有关腹腔镜与开腹直肠癌手术后复发率比较的随机对照研究（RCT）。由2名评价员独立筛选并提取数据资料，对符合纳入标准的研究使用RevMan5.1软件进行统计分析。［结果］ 共纳入12个临床随机对照研究，病例总数2 259例，其中LRR组1 158例，ORR组1 101例。腹腔镜直肠癌切除术对比开腹手术治疗直肠癌的术后总体复发率(OR=0.92，95％CI：0.66～1.28，P=0.61)、局部复发率(OR=0.79，95％CI：0.49～1.28，P=0.34)、远处转移率(OR=0.87，95％CI：0.59～1.27，P=0.47)及术后戳孔或切口种植转移率(OR=1.34，95％CI：0.07～24.10，P=0.84)差异均无统计学意义。［结论］ 腹腔镜直肠切除术对比传统开腹手术治疗直肠癌其术后长期肿瘤学效果相当，并不会导致术后各类复发率明显升高。但其长期生存效果需要更多大样本、高质量的前瞻性多中心的临床随机对照试验来证实。 |
| 英文摘要: |
| Abstract：［Purpose］ To compare the recurrence between laparoscopic rectectomy and conventional open rectectomy for rectal cancer with meta-analysis.［Methods］ Eligible articles were identified by searches of MEDLINE，EMBASE and the Cochrane database between January 1991 and October 2012 using the terms (laparoscopy，surgery，minimal invasive，rectectomy，rectal neoplasms and randomized controlled trial). Prospective randomized controlled trials（RCTs）were eligible if patients with rectal cancer were treated by laparoscopic surgery or open surgery. Data were extracted from these trials and analyzed by two independent reviewers. ［Results］ Twelve RCTs with 2 259 patients were involved. In the combined results，no significant difference in the OR for overall recurrence between the laparoscopic surgery group and open surgery group was found (OR=0.92，95％CI：0.66~1.28，P=0.61). Stratified by recurrence type，the combined results of the individual reports showed no significant differences for local recurrence(OR=0.79，95％CI：0.49~1.28，P=0.34)，distant metastasis(OR=0.87，95％CI：0.59~1.27，P=0.47) and port-site or wound-site recurrence(OR=1.34，95％CI：0.07~24.10，P=0.84) between the two surgical techniques. ［Conclusions］ The recurrence rate in patients with rectal cancer treated by laparoscopic surgery does not differ significantly from those by open surgery. Longer term follow up RCTs will further define outcomes of the two techniques in the treatment for rectal cancer. |
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