中华外科杂志
中華外科雜誌
중화외과잡지
CHINESE JOURNAL OF SURGERY
2013年
4期
308-313
,共6页
腹腔镜检查%胆囊切除术,腹腔镜%Meta分析
腹腔鏡檢查%膽囊切除術,腹腔鏡%Meta分析
복강경검사%담낭절제술,복강경%Meta분석
Laparoscopy%Cholecysectomy,laparoscopic%Meta-analysis
目的 评价单孑L腹腔镜胆囊切除术(SILC)的安全性和有效性.方法 收集2010年至2012年公开发表的SILC和传统腹腔镜胆囊切除术(LC)治疗胆囊良性疾病的中文和英文文献,对SILC组和LC组的术后并发症情况、术后恢复情况及术中情况进行荟萃分析.结果 筛选出符合纳入标准的研究11项共859例患者,SILC组449例,LC组410例.与LC组相比,SILC组术后美容效果更好,差异有统计学意义(Ⅳ=0.95,95％CI:0.56 ～ 1.34,Z=4.76,P=0.00),但在手术时间上SILC组明显长于LC组,差异有统计学意义(Ⅳ=16.66,95％CI:9.60 ～ 23.72,Z=4.62,P=0.00)；两组患者术中出血量、术中中转率、术后6 ～24 h疼痛情况、住院时间及术后并发症方面的差异则无统计学意义(P＞0.05).结论 SILC是安全可行的,具有优于LC的美容效果；但手术操作难度较大,手术时间长,有一定经验的医师方能施行.
目的 評價單孑L腹腔鏡膽囊切除術(SILC)的安全性和有效性.方法 收集2010年至2012年公開髮錶的SILC和傳統腹腔鏡膽囊切除術(LC)治療膽囊良性疾病的中文和英文文獻,對SILC組和LC組的術後併髮癥情況、術後恢複情況及術中情況進行薈萃分析.結果 篩選齣符閤納入標準的研究11項共859例患者,SILC組449例,LC組410例.與LC組相比,SILC組術後美容效果更好,差異有統計學意義(Ⅳ=0.95,95％CI:0.56 ～ 1.34,Z=4.76,P=0.00),但在手術時間上SILC組明顯長于LC組,差異有統計學意義(Ⅳ=16.66,95％CI:9.60 ～ 23.72,Z=4.62,P=0.00)；兩組患者術中齣血量、術中中轉率、術後6 ～24 h疼痛情況、住院時間及術後併髮癥方麵的差異則無統計學意義(P＞0.05).結論 SILC是安全可行的,具有優于LC的美容效果；但手術操作難度較大,手術時間長,有一定經驗的醫師方能施行.
목적 평개단혈L복강경담낭절제술(SILC)적안전성화유효성.방법 수집2010년지2012년공개발표적SILC화전통복강경담낭절제술(LC)치료담낭량성질병적중문화영문문헌,대SILC조화LC조적술후병발증정황、술후회복정황급술중정황진행회췌분석.결과 사선출부합납입표준적연구11항공859례환자,SILC조449례,LC조410례.여LC조상비,SILC조술후미용효과경호,차이유통계학의의(Ⅳ=0.95,95％CI:0.56 ～ 1.34,Z=4.76,P=0.00),단재수술시간상SILC조명현장우LC조,차이유통계학의의(Ⅳ=16.66,95％CI:9.60 ～ 23.72,Z=4.62,P=0.00)；량조환자술중출혈량、술중중전솔、술후6 ～24 h동통정황、주원시간급술후병발증방면적차이칙무통계학의의(P＞0.05).결론 SILC시안전가행적,구유우우LC적미용효과；단수술조작난도교대,수술시간장,유일정경험적의사방능시행.
Objective To study feasibility and security of single-incision laparoscopic cholecystectomy (SILC).Methods Clinical trials comparing SILC with conventional laparoscopic cholecystectomy (LC) for benign gallbladder disease published from 2010 to 2012 were retrieved.A metaanalysis was conducted to evaluate operative time,blood loss,conversion rate,post-operative pain,wound satisfaction score,post-operative hospital stay and post-operative complications between SILC group and LC group.A fixed effect model or random effect model was established to collect the data.Results Eleven random clinical trials on 859 patients qualified for the meta-analysis,449 patients being allocated to SILC and 410 patients to LC.There was no significant difference between SILC group and LC group for blood loss,conversion rate,post-operative pain,post-operative hospital stay and post-operative complications.However,operative time was significantly longer in SILC group than LC group (Ⅳ =16.66,95％ CI:9.60-23.72,Z =4.62,P =0.00).Furthermore,wound satisfaction score was significantly higher in SILC group than in LC group (Ⅳ=0.95,95％CI:0.56-1.34,Z=4.76,P=0.00).Conclusions SILC may be superior to LC in terms of cosmetic outcome,but not in operative time.Currently,SILC is a safe procedure for proper patients in experienced surgeons.
