CAJ | 학술논문

目的：探讨胃癌根治术中保留脾脏与切除脾脏的术后并发症及5年生存率情况。方法计算机检索Pubmed、EMABSE、CBM、维普、万方及中国知网数据库，检索时间截止至2014年2月，收集关于胃癌根治术中保留脾脏与切除脾脏的术后并发症及5年生存率的研究，由2名评价者按照纳入和排除标准独立选择文献、提取资料、评价质量，采用STATA 11?0软件进行分析，计算合并OR值及其95％CI并行敏感性分析和发表偏倚评估。结果最终纳入16篇文献，包括1949例切除脾脏患者（切除组）和2864例保留脾脏患者（保留组）。纳入文献的结果在术后并发症发生率和5年生存率的比较模型中均无异质性。各模型Meta分析结果显示：胃癌根治术中切除组的并发症发生率高于保留组，差异有统计学意义（ OR＝1?699，95％ CI：1?436～2?009）；且切除组的5年生存率低于保留组，差异亦有统计学意义（ OR＝0?402，95％ CI：0?363～0?445）。结论胃癌根治术中保留脾脏可降低术后并发症的发生，同时能提高患者生存率。
목적：탐토위암근치술중보류비장여절제비장적술후병발증급5년생존솔정황。방법계산궤검색Pubmed、EMABSE、CBM、유보、만방급중국지망수거고，검색시간절지지2014년2월，수집관우위암근치술중보류비장여절제비장적술후병발증급5년생존솔적연구，유2명평개자안조납입화배제표준독립선택문헌、제취자료、평개질량，채용STATA 11?0연건진행분석，계산합병OR치급기95％CI병행민감성분석화발표편의평고。결과최종납입16편문헌，포괄1949례절제비장환자（절제조）화2864례보류비장환자（보류조）。납입문헌적결과재술후병발증발생솔화5년생존솔적비교모형중균무이질성。각모형Meta분석결과현시：위암근치술중절제조적병발증발생솔고우보류조，차이유통계학의의（ OR＝1?699，95％ CI：1?436～2?009）；차절제조적5년생존솔저우보류조，차이역유통계학의의（ OR＝0?402，95％ CI：0?363～0?445）。결론위암근치술중보류비장가강저술후병발증적발생，동시능제고환자생존솔。
Objective To investigate the postoperative complications and 5-year survival rate of splenectomy and spleen pres-ervation in radical gastrectomy for gastric cancer. Methods All eligible case-control studies published up to Febuary 2014 were searched out from PubMed, EMABSE, CBM, CNKI, VIP and WanFang databases. Two reviewers independently identified the litera-ture according to inclusion and exclusion criteria. Meta-analysis was performed using STATA 11?0 software to analyze. Results A total of 16 studies comprising 1949 patients with splenectomy ( resection group) and 2864 patients with splenic preservation ( preservation group) were finally included. The included studies showed good homogeneity in the models of postoperative complications and 5-year survival rate. Overall, the rate of postoperative complications was higher ( OR=1?699,95% CI:1?436-2?009) and the 5-year survival rate was lower ( OR=0?402,95% CI:0?363-0?445) in resection group versus preservation group ( P<0?05) . Conclusion The pres-ervation of spleen in the radical gastrectomy for gastric cancer can reduce the incidence of postoperative complications and improve the survival of patients.