中华胃肠外科杂志
中華胃腸外科雜誌
중화위장외과잡지
CHINESE JOURNAL OF GASTROINTESTINAL SURGERY
2013年
7期
622-627
,共6页
直肠肿瘤,低位%腹会阴联合切除术%经肛提肌外腹会阴联合切除术%治疗效果%Meta分析
直腸腫瘤,低位%腹會陰聯閤切除術%經肛提肌外腹會陰聯閤切除術%治療效果%Meta分析
직장종류,저위%복회음연합절제술%경항제기외복회음연합절제술%치료효과%Meta분석
Rectal neoplasms,low%Abdominoperineal excision%Extralevator abdominoperineal excision%Treatment outcomes%Meta-analysis
目的 系统比较经肛提肌外腹会阴联合切除术(ELAPE)与传统腹会阴联合切除术(APE)对低位直肠癌的治疗效果.方法 计算机检索Cochrane图书馆、PubMed、EMbase、中国知网和维普等数据库中以低位直肠癌为研究对象、并设有ELAPE与APE对照的临床研究文献,采用Cochrane系统评价方法对两种术式的术中穿孔率、环周切缘阳性率、术后局部复发率及术后会阴切口并发症发生率进行Meta分析.结果 共6篇文献(1篇随机对照研究和5篇非随机对照研究)656例病例纳入研究,其中ELAPE组346例,APE组310例.Meta分析结果显示,ELAPE组环周切缘阳性率(RR=0.48,95％CI:0.36～0.65)和局部复发率(RR=0.43,95％CI:0.19～0.99)明显低于APE组；而两组患者术中穿孔率(RR=0.45,95％CI:0.15～1.37)和术后会阴切口并发症发生率(RR=1.20,95％CI:0.57～2.50)的差异无统计学意义.结论 相较于传统APE术,ELAPE术具有更低的环周切缘阳性率和局部复发率.
目的 繫統比較經肛提肌外腹會陰聯閤切除術(ELAPE)與傳統腹會陰聯閤切除術(APE)對低位直腸癌的治療效果.方法 計算機檢索Cochrane圖書館、PubMed、EMbase、中國知網和維普等數據庫中以低位直腸癌為研究對象、併設有ELAPE與APE對照的臨床研究文獻,採用Cochrane繫統評價方法對兩種術式的術中穿孔率、環週切緣暘性率、術後跼部複髮率及術後會陰切口併髮癥髮生率進行Meta分析.結果 共6篇文獻(1篇隨機對照研究和5篇非隨機對照研究)656例病例納入研究,其中ELAPE組346例,APE組310例.Meta分析結果顯示,ELAPE組環週切緣暘性率(RR=0.48,95％CI:0.36～0.65)和跼部複髮率(RR=0.43,95％CI:0.19～0.99)明顯低于APE組；而兩組患者術中穿孔率(RR=0.45,95％CI:0.15～1.37)和術後會陰切口併髮癥髮生率(RR=1.20,95％CI:0.57～2.50)的差異無統計學意義.結論 相較于傳統APE術,ELAPE術具有更低的環週切緣暘性率和跼部複髮率.
목적 계통비교경항제기외복회음연합절제술(ELAPE)여전통복회음연합절제술(APE)대저위직장암적치료효과.방법 계산궤검색Cochrane도서관、PubMed、EMbase、중국지망화유보등수거고중이저위직장암위연구대상、병설유ELAPE여APE대조적림상연구문헌,채용Cochrane계통평개방법대량충술식적술중천공솔、배주절연양성솔、술후국부복발솔급술후회음절구병발증발생솔진행Meta분석.결과 공6편문헌(1편수궤대조연구화5편비수궤대조연구)656례병례납입연구,기중ELAPE조346례,APE조310례.Meta분석결과현시,ELAPE조배주절연양성솔(RR=0.48,95％CI:0.36～0.65)화국부복발솔(RR=0.43,95％CI:0.19～0.99)명현저우APE조；이량조환자술중천공솔(RR=0.45,95％CI:0.15～1.37)화술후회음절구병발증발생솔(RR=1.20,95％CI:0.57～2.50)적차이무통계학의의.결론 상교우전통APE술,ELAPE술구유경저적배주절연양성솔화국부복발솔.
Objective To evaluate the perforation,circumferential resection margin (CRM) and postoperative perineal wound complications after extralevator abdominoperineal excision (ELAPE) and conventional abdominoperineal excision (APE) for low rectal cancer by using systematic review method.Methods The Cochrane Library,PubMed,EMbase,CNKI and VIP database were searched for literatures in which ELAPE and APE were compared for the treatment of low rectal cancer.Meta-analysis was performed to deal with data extracted by Cochrane Systematic Reviews methods.Results Six studies met the inclusion criteria including one randomized control study and five non-randomized control studies with a total of 656 cases including 346 cases of ELAPE and 310 cases of APE.Meta-analysis showed a lower positive CRM rate(RR=0.48,95％CI:0.36-0.65) and a lower local recurrence rate(RR=0.43,95％CI:0.19-0.99) in ELAPE compared with APE.There were no significant differences in operative perforation rate (RR =0.45,95％ CI:0.15-1.37) and post-operative perineal wound complications rate (RR=1.20,95％CI:0.57-2.50) between the two surgical procedures.Conclusion ELAPE is associated with lower rates of positive CRM and local recurrence compared with APE.
