全科医学临床与教育
全科醫學臨床與教育
전과의학림상여교육
CLINICAL EDUCATION OF GENERAL PRACTICE
2013年
4期
366-372
,共7页
王伟%季科炜%胡耕远%王津道
王偉%季科煒%鬍耕遠%王津道
왕위%계과위%호경원%왕진도
胃间质瘤%胃切除术%腹腔镜%并发症%Meta分析
胃間質瘤%胃切除術%腹腔鏡%併髮癥%Meta分析
위간질류%위절제술%복강경%병발증%Meta분석
gastric stromal tumor%gastrectomy%laparoscopy%complications%meta-analysis
目的从循证医学角度评价胃间质瘤腹腔镜手术切除和开腹手术切除的安全性与有效性。方法检索PubMed、Cochrane Library、Web of Science、中国生物医学文献数据库、中国期刊全文数据库和万方数据库1995年1月至2013年2月公开发表的有关腹腔镜胃间质瘤切除术（LAP组）和开腹胃间质瘤切除术（OPEN组）的对比性文献。按纳入标准筛选文献，提取临床效应指标，并进行文献质量评分，采用RevMan 5.1软件对所纳入的研究进行Meta分析。结果初步检索相关文献共169篇，最终纳入19个对照试验。Meta分析结果显示：LAP组与OPEN组手术时间差异无统计学意义（WMD=-5.17，95% CI为-16.59~6.26， P＞0.05），但LAP组术中失血量明显少于OPEN组（WMD=-58.93，95% CI为-82.51~-35.34， P＜0.05）。术后恢复方面，与OPEN组比较，LAP组术后肛门排气时间早（WMD=-0.70，95% CI为-0.96~-0.45， P＜0.05）；进食时间早（WMD=-1.33，95% CI：-1.82~-0.83， P＜0.05）；总体并发症少（RR=0.40，95%CI为0.24~0.66， P＜0.05）；住院时间短（WMD=-3.21，95%CI为-3.90~-2.52， P＜0.05）。结论腹腔镜胃间质瘤切除术安全可行，与开腹手术比较具有术中出血少、术后恢复快和并发症少等优点。
目的從循證醫學角度評價胃間質瘤腹腔鏡手術切除和開腹手術切除的安全性與有效性。方法檢索PubMed、Cochrane Library、Web of Science、中國生物醫學文獻數據庫、中國期刊全文數據庫和萬方數據庫1995年1月至2013年2月公開髮錶的有關腹腔鏡胃間質瘤切除術（LAP組）和開腹胃間質瘤切除術（OPEN組）的對比性文獻。按納入標準篩選文獻，提取臨床效應指標，併進行文獻質量評分，採用RevMan 5.1軟件對所納入的研究進行Meta分析。結果初步檢索相關文獻共169篇，最終納入19箇對照試驗。Meta分析結果顯示：LAP組與OPEN組手術時間差異無統計學意義（WMD=-5.17，95% CI為-16.59~6.26， P＞0.05），但LAP組術中失血量明顯少于OPEN組（WMD=-58.93，95% CI為-82.51~-35.34， P＜0.05）。術後恢複方麵，與OPEN組比較，LAP組術後肛門排氣時間早（WMD=-0.70，95% CI為-0.96~-0.45， P＜0.05）；進食時間早（WMD=-1.33，95% CI：-1.82~-0.83， P＜0.05）；總體併髮癥少（RR=0.40，95%CI為0.24~0.66， P＜0.05）；住院時間短（WMD=-3.21，95%CI為-3.90~-2.52， P＜0.05）。結論腹腔鏡胃間質瘤切除術安全可行，與開腹手術比較具有術中齣血少、術後恢複快和併髮癥少等優點。
목적종순증의학각도평개위간질류복강경수술절제화개복수술절제적안전성여유효성。방법검색PubMed、Cochrane Library、Web of Science、중국생물의학문헌수거고、중국기간전문수거고화만방수거고1995년1월지2013년2월공개발표적유관복강경위간질류절제술（LAP조）화개복위간질류절제술（OPEN조）적대비성문헌。안납입표준사선문헌，제취림상효응지표，병진행문헌질량평분，채용RevMan 5.1연건대소납입적연구진행Meta분석。결과초보검색상관문헌공169편，최종납입19개대조시험。Meta분석결과현시：LAP조여OPEN조수술시간차이무통계학의의（WMD=-5.17，95% CI위-16.59~6.26， P＞0.05），단LAP조술중실혈량명현소우OPEN조（WMD=-58.93，95% CI위-82.51~-35.34， P＜0.05）。술후회복방면，여OPEN조비교，LAP조술후항문배기시간조（WMD=-0.70，95% CI위-0.96~-0.45， P＜0.05）；진식시간조（WMD=-1.33，95% CI：-1.82~-0.83， P＜0.05）；총체병발증소（RR=0.40，95%CI위0.24~0.66， P＜0.05）；주원시간단（WMD=-3.21，95%CI위-3.90~-2.52， P＜0.05）。결론복강경위간질류절제술안전가행，여개복수술비교구유술중출혈소、술후회복쾌화병발증소등우점。
Objective To evaluate the effect and safety of laparoscopic versus open resection for gastric stromal tumors with meta-analysis. Methods Database including PubMed, Cochrane Library, Web of Science, SinoMed, CNKI, Wang-Fang data were searched from January, 1995 to February, 2013 to collect the comparative studies of laparoscopic (lap group) and open resection (open group) for gastric stromal tumors. The studies were screened according to the inclusion and exclusion criteria. After extracting data and assessing the quality of the included studies, meta-analysis was conducted using RevMan 5.1 software. Results Of the 169 identified studies, 19 studies were included finally. The operation time was similar between the two groups (WMD=-5.17, 95% CI: -16.59~6.26, P>0.05). Compared with open group, the blood loss intraoperative of lap group was significantly less (WMD=-58.93, 95%CI:-82.51~-35.34, P<0.05). The ex-hausting time of lap group was significantly earlier (WMD=-0.70, 95% CI: -0.96~-0.45, P<0.05) as well as oral diet time (WMD=-1.33, 95% CI: -1.82~-0.83, P<0.05). The hospital stay of lap group was significantly shorter (WMD=-3.21, 95% CI: -3.90~-2.52,P<0.05) while the overall complications was significantly decreased (RR=0.40, 95% CI:0.24~0.66, P<0.05). Conclusions Laparoscopic resection for gastrointestinal stromal tumors of the stomach is a safe and feasible procedure with less blood loss , less overall complications and quick recovery.
