中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2014年
4期
272-276
,共5页
曹宏%田晓丰%孙月芳%王春田%房学东
曹宏%田曉豐%孫月芳%王春田%房學東
조굉%전효봉%손월방%왕춘전%방학동
胰腺肿瘤%胰体尾切除术%胰瘘%手工缝合%闭合器%Meta分析
胰腺腫瘤%胰體尾切除術%胰瘺%手工縫閤%閉閤器%Meta分析
이선종류%이체미절제술%이루%수공봉합%폐합기%Meta분석
Pancreatic neoplasms%Distal pancreatomy%Pancreatic fistula%Hand suture%Stapler%Meta analysis
目的 比较胰体尾切除术采用手工缝合与器械闭合胰腺断端预防胰瘘的效果.方法 检索2011年12月以前医学文献检索服务系统和电子数据库,经过筛选,纳入前瞻性对照研究和回顾性研究,提取数据资料进行Meta分析.所纳入研究中胰瘘的诊断标准均采用国际胰腺外科组织胰瘘诊断标准.采用I2对异质性进行定量分析.采用固定或随机效应模型合并数据.计数资料采用优势比(OR)及95％可信区间(95％ CI)表示.结果 共纳入10篇比较胰体尾切除术手工缝合与器械闭合断端胰瘘发生率的文献,其中前瞻性随机对照研究l篇,前瞻性非随机对照研究3篇,回顾性研究6篇.10篇文献中手工组患者1 441例,器械组患者612例.Meta分析结果显示:手术组与器械组患者术后胰瘘发生率比较,差异无统计学意义(OR=1.10,95％ CI:0.86～1.40,P ＞0.05).其中6篇文献比较了手工缝合与器械闭合严重胰瘘(B、C级胰瘘)发生率,手工组患者1 182例,器械组患者383例.Meta分析结果显示:手术组与器械组患者术后严重胰瘘发生率比较,差异无统计学意义(OR=1.33,95％ CI:0.94 ～ 1.88,P＞0.05).结论 胰体尾切除术采用手工缝合与器械闭合胰腺断端预防胰瘘的效果相当,器械闭合只是为胰体尾切除术中胰腺断端的处理方式提供了另一选择.
目的 比較胰體尾切除術採用手工縫閤與器械閉閤胰腺斷耑預防胰瘺的效果.方法 檢索2011年12月以前醫學文獻檢索服務繫統和電子數據庫,經過篩選,納入前瞻性對照研究和迴顧性研究,提取數據資料進行Meta分析.所納入研究中胰瘺的診斷標準均採用國際胰腺外科組織胰瘺診斷標準.採用I2對異質性進行定量分析.採用固定或隨機效應模型閤併數據.計數資料採用優勢比(OR)及95％可信區間(95％ CI)錶示.結果 共納入10篇比較胰體尾切除術手工縫閤與器械閉閤斷耑胰瘺髮生率的文獻,其中前瞻性隨機對照研究l篇,前瞻性非隨機對照研究3篇,迴顧性研究6篇.10篇文獻中手工組患者1 441例,器械組患者612例.Meta分析結果顯示:手術組與器械組患者術後胰瘺髮生率比較,差異無統計學意義(OR=1.10,95％ CI:0.86～1.40,P ＞0.05).其中6篇文獻比較瞭手工縫閤與器械閉閤嚴重胰瘺(B、C級胰瘺)髮生率,手工組患者1 182例,器械組患者383例.Meta分析結果顯示:手術組與器械組患者術後嚴重胰瘺髮生率比較,差異無統計學意義(OR=1.33,95％ CI:0.94 ～ 1.88,P＞0.05).結論 胰體尾切除術採用手工縫閤與器械閉閤胰腺斷耑預防胰瘺的效果相噹,器械閉閤隻是為胰體尾切除術中胰腺斷耑的處理方式提供瞭另一選擇.
목적 비교이체미절제술채용수공봉합여기계폐합이선단단예방이루적효과.방법 검색2011년12월이전의학문헌검색복무계통화전자수거고,경과사선,납입전첨성대조연구화회고성연구,제취수거자료진행Meta분석.소납입연구중이루적진단표준균채용국제이선외과조직이루진단표준.채용I2대이질성진행정량분석.채용고정혹수궤효응모형합병수거.계수자료채용우세비(OR)급95％가신구간(95％ CI)표시.결과 공납입10편비교이체미절제술수공봉합여기계폐합단단이루발생솔적문헌,기중전첨성수궤대조연구l편,전첨성비수궤대조연구3편,회고성연구6편.10편문헌중수공조환자1 441례,기계조환자612례.Meta분석결과현시:수술조여기계조환자술후이루발생솔비교,차이무통계학의의(OR=1.10,95％ CI:0.86～1.40,P ＞0.05).기중6편문헌비교료수공봉합여기계폐합엄중이루(B、C급이루)발생솔,수공조환자1 182례,기계조환자383례.Meta분석결과현시:수술조여기계조환자술후엄중이루발생솔비교,차이무통계학의의(OR=1.33,95％ CI:0.94 ～ 1.88,P＞0.05).결론 이체미절제술채용수공봉합여기계폐합이선단단예방이루적효과상당,기계폐합지시위이체미절제술중이선단단적처리방식제공료령일선택.
Objective To compare the incidence of pancreatic fistula after hand and stapler suture in preventing pancreatic fistula after distal pancreatectomy.Methods The literatures published before December 2011 were retrieved from SinoMed and electronic database.Prospective controlled trials and retrospective reports were screened out for Meta analysis.The diagnostic criteria of pancreatic fistula were based on the criteria formulated by the International Study group of Pancreatic Fistula.The heterogeneity of the studies was analyzed using the Ⅰ2 test.The data were integrated using the fixed or random effect model.The results of the Meta analysis were presented with odds ratio (OR) and 95％ confidence interval (95％ CI).Results According to the selection criteria,lO literatures were selected which included 1 prospective randomized controlled study,3 prospective nonrandomized controlled studies and 6 retrospective studies.There were 1 441 cases in the hand suture group and 612 cases in the stapler suture group.There was no significant difference in the incidences of the pancreatic fistula between the hand suture group and the stapler suture group (OR =1.10,95％ CI:0.86-1.40,P ＞0.05).Six studies compared the incidences of severe pancreatic fistula (grade B or C) between the hand suture group and the stapler suture group.There were 1 182 cases in the hand suture group and 383 cases in the stapler suture group.There was no significant difference in the incidence of severe pancreatic fistula between the hand suture group and the stapler suture group (OR=1.33,95％CI:0.94-1.88,P＞0.05).Conclusion The efficacies of hand suture and stapler suture in preventing pancreatic fistula after distal pancreatectomy are comparable.Stapler suture provides an another option in distal pancreatectomy.
