中华肝胆外科杂志
中華肝膽外科雜誌
중화간담외과잡지
CHINESE JOURNAL OF HEPATOBILIARY SURGERY
2013年
2期
137-142
,共6页
何彦安%雷正明%丁辉%叶明新%文亚兰
何彥安%雷正明%丁輝%葉明新%文亞蘭
하언안%뢰정명%정휘%협명신%문아란
胆囊切除术,腹腔镜%Meta分析%随机对照试验
膽囊切除術,腹腔鏡%Meta分析%隨機對照試驗
담낭절제술,복강경%Meta분석%수궤대조시험
Cholecystectomy,laparoscopic%Meta-analysis%Randomized controlled trials
目的 评价经脐单孔和传统腹腔镜胆囊切除术的安全性和疗效.方法 电子检索1997年1月至2012年4月的PubMde数据库、EMBASE、the Cochrane Controlled Trials Register、中国生物医学文献数据库.纳入比较经脐单孔与传统行腹腔镜胆囊切除术,并观察两组术中中转、术中出血、手术时间、术后并发症、切口满意度、术后疼痛和住院时间的随机对照研究.由两名评价员独立收集数据并对所得数据及试验质量进行评价,采用Cochrane协作网专用软件RevMan 5.1版进行统计分析.结果 共有12项试验、892例患者符合纳入标准.Meta分析结果提示:与传统腹腔镜胆囊切除术相比,经脐单孔腹腔镜胆囊切除术在术中中转(OR=0.70,95％CI:0.13～3.77,P=0.68)、术后并发症(OR=1.13,95％CI:0.72～1.78,P=0.59)和术后疼痛(WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57)方面差异无统计学意义.而在术中出血(WMD＝1.43,95％ CI:0.09～2.78,P＜0.05)、手术时间(WMD＝16.79,95％CI:9.05～24.52,P＜0.01)、切口满意度(WMD=1.28,95％CI:1.09～1.47,P＜0.01)和住院天数(WMD＝-0.30,95％CI:-0.58～-0.02,P＜0.05)方面,差异均有统计学意义.结论 分析显示,经脐单孔电视腹腔镜相比于传统多孔电视腹腔镜胆囊切除术,虽然术中出血增多、手术时间延长,但具有术后切口满意度高、恢复快的优点.
目的 評價經臍單孔和傳統腹腔鏡膽囊切除術的安全性和療效.方法 電子檢索1997年1月至2012年4月的PubMde數據庫、EMBASE、the Cochrane Controlled Trials Register、中國生物醫學文獻數據庫.納入比較經臍單孔與傳統行腹腔鏡膽囊切除術,併觀察兩組術中中轉、術中齣血、手術時間、術後併髮癥、切口滿意度、術後疼痛和住院時間的隨機對照研究.由兩名評價員獨立收集數據併對所得數據及試驗質量進行評價,採用Cochrane協作網專用軟件RevMan 5.1版進行統計分析.結果 共有12項試驗、892例患者符閤納入標準.Meta分析結果提示:與傳統腹腔鏡膽囊切除術相比,經臍單孔腹腔鏡膽囊切除術在術中中轉(OR=0.70,95％CI:0.13～3.77,P=0.68)、術後併髮癥(OR=1.13,95％CI:0.72～1.78,P=0.59)和術後疼痛(WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57)方麵差異無統計學意義.而在術中齣血(WMD＝1.43,95％ CI:0.09～2.78,P＜0.05)、手術時間(WMD＝16.79,95％CI:9.05～24.52,P＜0.01)、切口滿意度(WMD=1.28,95％CI:1.09～1.47,P＜0.01)和住院天數(WMD＝-0.30,95％CI:-0.58～-0.02,P＜0.05)方麵,差異均有統計學意義.結論 分析顯示,經臍單孔電視腹腔鏡相比于傳統多孔電視腹腔鏡膽囊切除術,雖然術中齣血增多、手術時間延長,但具有術後切口滿意度高、恢複快的優點.
목적 평개경제단공화전통복강경담낭절제술적안전성화료효.방법 전자검색1997년1월지2012년4월적PubMde수거고、EMBASE、the Cochrane Controlled Trials Register、중국생물의학문헌수거고.납입비교경제단공여전통행복강경담낭절제술,병관찰량조술중중전、술중출혈、수술시간、술후병발증、절구만의도、술후동통화주원시간적수궤대조연구.유량명평개원독립수집수거병대소득수거급시험질량진행평개,채용Cochrane협작망전용연건RevMan 5.1판진행통계분석.결과 공유12항시험、892례환자부합납입표준.Meta분석결과제시:여전통복강경담낭절제술상비,경제단공복강경담낭절제술재술중중전(OR=0.70,95％CI:0.13～3.77,P=0.68)、술후병발증(OR=1.13,95％CI:0.72～1.78,P=0.59)화술후동통(WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57)방면차이무통계학의의.이재술중출혈(WMD＝1.43,95％ CI:0.09～2.78,P＜0.05)、수술시간(WMD＝16.79,95％CI:9.05～24.52,P＜0.01)、절구만의도(WMD=1.28,95％CI:1.09～1.47,P＜0.01)화주원천수(WMD＝-0.30,95％CI:-0.58～-0.02,P＜0.05)방면,차이균유통계학의의.결론 분석현시,경제단공전시복강경상비우전통다공전시복강경담낭절제술,수연술중출혈증다、수술시간연장,단구유술후절구만의도고、회복쾌적우점.
Objectives To evaluate the efficacy and safety of single-incision versus conventional laparoscopic cholecystectomy.Methods We searched electronic databases (PubMed,EMBASE,Cochrane Library,Chinese Biomedicine databases) from January 2000 to April 2012.Personal contact with experts in the field of laparoscopic cholecystectomy was performed to identify further potentially relevant clinical trials.Randomized controlled trials conducted on single-incision versus conventional laparoscopic cholecystectomy were analysed to compare conversion rates,blood loss,operation time,postoperative complications,wound satisfaction score,postoperative pain score and postoperative duration of hospitalization.Data were extracted by two reviewers independently.Statistical analysis was performed by using the RevMan 5.1 software.Results Twelve studies involving 915 patients met the inclusion criteria.When compared with conventional laparoscopic cholecystectomy (LC),the singleincision laparoscopic cholecystectomy (SILC) group showed no significant difference in conversion rate (OR=0.70,95％CI: 0.13～3.77,P=0.68),postoperative complications (OR=1.13,95％CI:0.72～1.78,P＝0.59) and postoperative pain scores (WMD＝-0.18,95％CI:-0.78～-0.43,P=0.57) . There was a significant increase in operative blood loss (WMD ＝ 1.43,95 ％ CI: 0.09 ～2.78,P＜0.05),increase in operative time (WMD=16.79,95％CI: 9.05～24.52,P＜0.01),but an increase in wound satisfaction score (WMD=1.28,95％CI..1.09～1.47,P＜0.01).The postoperative duration of hospitalization was significantly shorter (WMD =-0.30,95％ CI:-0.58 ～-0.02,P＜0.05).Conclusions Current evidence suggests that there is no significant difference in conversion rate or postoperative complications between SILC and LC.Although SILC requires a longer operative time and there is more blood loss when compared with LC,the SILC is superior in wound satisfaction score and in duration of hospitalization.
