CAJ | 학술논문

目的系统评价快速康复外科(FTS)联合腹腔镜胃癌根治术的安全性和有效性.方法计算机检索1994年1月至2012年12月CNKI、万方、维普、PubMed、EMBASE、Cochrane Library数据库关于FTS联合腹腔镜对照两者单独应用于胃癌根治术的随机对照试验(RCT)或临床对照试验(CCT),对符合标准的文献提取相关数据后采用RevMan5.1.0软件进行Meta分析.结果 3项RCT和2项CCT纳入研究,共有524例患者,其中试验组(FTS联合腹腔镜)257例,对照组(单纯FTS或单纯腹腔镜)267例.Meta分析结果显示:试验组较对照组术后首次排气时间明显提前(SMD=-1.29,95 ％CI:-2.17～-0.40,P＜0.05),住院时间明显缩短(WMD=-1.72,95％CI:-2.56～-0.89,P＜0.05),术后并发症发生率明显降低(OR =0.51,95％CI:0.31～0.84,P＜0.05),但手术时间、淋巴结清扫数量、术中出血量和住院费用方面两组差异无统计学意义(均P＞0.05).结论 FTS联合腹腔镜胃癌根治术能有效促进术后肠功能恢复,缩短住院时间,减少术后并发症,加速患者康复.
목적 계통평개쾌속강복외과(FTS)연합복강경위암근치술적안전성화유효성.방법 계산궤검색1994년1월지2012년12월CNKI、만방、유보、PubMed、EMBASE、Cochrane Library수거고관우FTS연합복강경대조량자단독응용우위암근치술적수궤대조시험(RCT)혹림상대조시험(CCT),대부합표준적문헌제취상관수거후채용RevMan5.1.0연건진행Meta분석.결과 3항RCT화2항CCT납입연구,공유524례환자,기중시험조(FTS연합복강경)257례,대조조(단순FTS혹단순복강경)267례.Meta분석결과현시:시험조교대조조술후수차배기시간명현제전(SMD=-1.29,95 ％CI:-2.17～-0.40,P＜0.05),주원시간명현축단(WMD=-1.72,95％CI:-2.56～-0.89,P＜0.05),술후병발증발생솔명현강저(OR =0.51,95％CI:0.31～0.84,P＜0.05),단수술시간、림파결청소수량、술중출혈량화주원비용방면량조차이무통계학의의(균P＞0.05).결론 FTS연합복강경위암근치술능유효촉진술후장공능회복,축단주원시간,감소술후병발증,가속환자강복.
Objective To conduct a systemic review of the safety and efficacy of fast-track surgery combined with laparoscopy in radical gastrectomy for gastric cancer.Methods The databases,including CNKI,Wangfang,VIP,PubMed,EMBASE and Cochrane Library,were searched to collect randomized controlled trials(RCTs)or clinical controlled trials(CCTs)on the comparison of fast-track surgery combined with laparoscopy versus fast-track surgery or laparoscopy separately used in radical gastrectomy for gastric cancer between January 1994 and December 2012.After data were extracted,meta-analysis was conducted by using RevMan 5.1.0 software.Results A total of 3 RCTs and 2 CCTs,involving 524 patients,were included.There were 257 patients in the study group and 267 patients in the control group.Compared with the control group,the study group had earlier first flatus(SMD=-1.29,95％CI:-2.17 to-0.40,P＜0.05),shorter postoperative hospital stay(WMD=-1.72,95％CI:-2.56 to-0.89,P＜0.05)and lower postoperative complication rate(0R=0.51,95％CI:0.31 to 0.84,P＜0.05).However,no significant differences were found in operation time,harvested lymph node number,intraoperative blood loss and hospital charge(P＞0.05).Conclusion Fast-track surgery combined with laparoscopy in radical gastrectomy for gastric cancer can accelerate postoperative rehabilitation by promoting postoperative bowel function recovery,and decreasing postoperative hospital stay and complication rate.