| 鲁 英,丁佳吉,刘 佩.乳腺癌腔镜腋窝淋巴结清扫术Meta分析[J].肿瘤学杂志,2019,25(3):227-233. |
| 乳腺癌腔镜腋窝淋巴结清扫术Meta分析 |
| Mastoscopic Axillary Lymph Node Dissection in Breast Cancer：A Meta-analysis |
| 投稿时间：2018-01-08 |
| DOI：10.11735/j.issn.1671-170X.2019.03.B011 |
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| 中文关键词: 乳腺癌 腔镜腋窝淋巴结清扫 meta分析 |
| 英文关键词:breast cancer mastoscopic axillary lymph node disection meta-analysis |
| 基金项目:国家重点研发计划（2016YFC0905900） |
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| 摘要点击次数: 1864 |
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| 中文摘要: |
| 摘 要： ［目的］ 探讨腔镜下腋窝淋巴结清扫术在乳腺癌外科治疗中的可行性、有效性及安全性。［方法］ 检索Cochrane、Pubmed、EMbase、中国知网、维普及万方数据库相关文献，时间截止在2017年6月以前，对符合纳入标准的所有文献进行相关的质量评价和荟萃分析。［结果］ 最终纳入12项随机对照试验，共包括1983例患者。腔镜与传统开放性腋窝淋巴结清扫手术相比，前者在术中出血量(SMD=－4.71，95%CI：－6.15~－3.27，P<0.01)、术后腋窝引流量(SMD=－4.26，95%CI：－5.10~－3.42，P<0.01)、住院时间(SMD=－1.24，95%CI：－1.75~－0.74，P<0.01)及术后相关并发症发生率(OR=0.22，95%CI：0.11~0.42，P<0.01)均少于后者，两组方案在手术时间(SMD=－0.47，95%CI：－1.42~0.48，P=0.34)、术中清扫淋巴结数目(SMD=0.10，95%CI：－0.05~0.24，P=0.18)、住院费用(SMD=1.65，95%CI：－1.32~4.63，P=0.28)及术后复发转移发生率(OR=0.75，95%CI：0.33~1.71，P=0.49)差异无统计学意义。［结论］ 在保证不影响患者预后的前提下，腔镜下腋窝淋巴结清扫术可以减轻对患者的创伤，同时可以减少术后并发症的发生，为该微创技术在我国临床领域的进一步开展提供了参考依据。 |
| 英文摘要: |
| Abstract：［Objective］ To investigate the feasibility，effectiveness and safety of mastoscopic axillary lymph node dissection for patients with breast cancer. ［Methods］ Relevant studies were retrieved from Cochrane，Pubmed，EMbase，CNKI，VIP，Wanfang database from inception to June 2017，the literatures meeting the inclusion criteria were reviewed and meta-analysis was performed. ［Results］ Twelve randomized controlled studies were finally included involving 1983 breast cancer patients. Meta-analysis showed that the intraoperative blood loss(SMD=－4.71，95%CI：－6.15~－3.27，P<0.01)，postoperative drainage(SMD=－4.26，95%CI：－5.10~－3.42，P<0.01)，length of hospital stay(SMD=－1.24，95%CI：－1.75~－0.74，P<0.01) and postoperative complications(OR=0.22，95%CI：0.11~0.42，P<0.01) were less in mastoscopic axillary lymph node dissection than those in conventional axillary lymph node dissection. There was no significant difference in the operation time(SMD=－0.47，95%CI：－1.42~0.48，P=0.34)，the number of axillary lymph nodes dissected(SMD=0.10，95%CI：-0.05~0.24，P=0.18)，hospitalization costs(SMD=1.65，95%CI：－1.32~4.63，P=0.28)，postoperative recurrence and metastasis rates(OR=0.75，95%CI：0.33~1.71，P=0.49) between the two groups. ［Conclusion］ Mastoscopic axillary lymph node dissection can reduce the trauma and the incidence of postoperative complications without affecting the prognosis of patients. |
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