CAJ | 학술논문

目的：评价经腹腔镜与开放腹股沟淋巴结清扫术的疗效，为临床治疗方案的选择提供循证依据。方法检索PubMed、Cochrane图书馆、Elsevier、中国期刊全文数据库（CNKI）及万方等数据库有关腹腔镜下腹股沟淋巴结清扫术与开放腹股沟淋巴结清扫术疗效比较的临床对照研究相关文献，按纳入排除标准由2名研究者独立进行筛选并提取相关资料，采用Rev-Man5．2软件进行Meta分析。结果4篇文献纳入分析，腹股沟淋巴结清扫术共146例，其中腹腔镜手术61例，开放手术85例。结果表明，两种术式手术时间[加权均数差（WMD）＝32．33，95％CI-25．70～90．36，P＝0．27]、术中失血量（WMD＝9．10，95％CI-76．03～94．23，P＝0．83）、术后淋巴结清扫数量（WMD＝0．77，95％CI-1．66～3．20，P＝0．53）、阳性淋巴结数量（WMD＝0．08，95％CI-0．23～0．40，P＝0．61）、术后引流管留置时间（WMD＝-1．30，95％CI-6．40～3．80，P＝0．62）、住院时间（WMD＝-4．02，95％CI-10．19～2．15，P＝0．20）比较，差异无统计学意义（P＞0．05）；而两种术式的手术并发症比较，差异有统计学意义（OR＝0．08，95％CI0．03～0．26，P＜0．01）。结论腹腔镜腹股沟淋巴结清扫术疗效与开放手术相当，但手术并发症较开放手术少。
목적：평개경복강경여개방복고구림파결청소술적료효，위림상치료방안적선택제공순증의거。방법검색PubMed、Cochrane도서관、Elsevier、중국기간전문수거고（CNKI）급만방등수거고유관복강경하복고구림파결청소술여개방복고구림파결청소술료효비교적림상대조연구상관문헌，안납입배제표준유2명연구자독립진행사선병제취상관자료，채용Rev-Man5．2연건진행Meta분석。결과4편문헌납입분석，복고구림파결청소술공146례，기중복강경수술61례，개방수술85례。결과표명，량충술식수술시간[가권균수차（WMD）＝32．33，95％CI-25．70～90．36，P＝0．27]、술중실혈량（WMD＝9．10，95％CI-76．03～94．23，P＝0．83）、술후림파결청소수량（WMD＝0．77，95％CI-1．66～3．20，P＝0．53）、양성림파결수량（WMD＝0．08，95％CI-0．23～0．40，P＝0．61）、술후인류관류치시간（WMD＝-1．30，95％CI-6．40～3．80，P＝0．62）、주원시간（WMD＝-4．02，95％CI-10．19～2．15，P＝0．20）비교，차이무통계학의의（P＞0．05）；이량충술식적수술병발증비교，차이유통계학의의（OR＝0．08，95％CI0．03～0．26，P＜0．01）。결론복강경복고구림파결청소술료효여개방수술상당，단수술병발증교개방수술소。
Objective To evaluate the effects between video endoscopic inguinal lymphadenectomy (VEIL ) and open inguinal lymphadenectomy(OIL) to provide the evidence-based basis for the selection of the clinical therapy schemes .Methods The related clinical controlled trial literature on the effective comparison of VEIL and OIL were retrieved from the databases of PubMed ,Co-chrane library ,Elsevier ,CNKI and Wanfang database .The screening was independently performed by 2 reviewers according to the including and excluding criteria .The related data were extracted and performed the meta analysis by the RevMan 5 .2 software .Re-sults A total of 4 trials were included .There were 146 cases of inguinal lymphadenectomies ,in which 61 cases were VEIL and 85 cases were OIL .The meta-analysis results showed that there were no statistical differences between the two operation modes in terms of the operative time(WMD=32 .33 ,95% CI -25 .70-90 .36 ,P=0 .27) ,intraoperative blood loss(WMD=9 .10 ,95% CI -76 .03-94 .23 ,P=0 .83) ,number of removed lymph nodes(WMD=0 .77 ,95% CI -1 .66-3 .20 ,P=0 .53) ,number of positive re-moved lymph nodes(WMD=0 .08 ,95% CI -0 .23-0 .40 ,P=0 .61) ,postoperative drainage time(WMD= -1 .30 ,95% CI -6 .40 -3 .80 ,P=0 .62) ,postoperative hospital stay (WMD= -4 .02 ,95% CI -10 .19-2 .15 ,P=0 .20) ,but the difference between VEIL and OIL in term of surgical complications had statistical significance (OR=0 .08 ,95% CI 0 .03-0 .26 ,P<0 .01) .Conclusion VEIL has equivalent efficacy to OIL ,but has less surgical complications .