中华泌尿外科杂志
中華泌尿外科雜誌
중화비뇨외과잡지
CHINESE JOURNAL OF UROLOGY
2015年
8期
615-619
,共5页
谢立平%王潇%郑祥义%刘犇%纪阿林%于亚赛
謝立平%王瀟%鄭祥義%劉犇%紀阿林%于亞賽
사립평%왕소%정상의%류분%기아림%우아새
耻骨后前列腺癌根治术%标准腹腔镜下前列腺癌根治术%荟萃分析%临床研究
恥骨後前列腺癌根治術%標準腹腔鏡下前列腺癌根治術%薈萃分析%臨床研究
치골후전렬선암근치술%표준복강경하전렬선암근치술%회췌분석%림상연구
Standard laparoscopic radical prostatectomy%Retropubic radical prostatectomy%Meta-analysis%Clinical research
目的 采用荟萃分析的方法比较标准腹腔镜下根治性前列腺切除术(standard laparoscopic radical prostatectomy,SLRP)与耻骨后根治性前列腺切除术(retropubic radical prostatectomy,RRP)治疗局限性前列腺癌的效果.方法 通过计算机在PubMed、Web of Science、Cochrane Library及EMBASE数据库(1992年1月至2015年4月)中检索相关文献,入选文献必须对比SLRP与RRP的疗效,包含手术时间、出血量、输血率、留置导尿时间、住院时间、切缘阳性率、围手术期并发症、性功能恢复情况以及尿失禁恢复情况等指标中的至少一项,运用荟萃分析比较两种手术方式在治疗局限性前列腺癌疗效上的差异.结果 经筛选后共17篇文献纳入分析,其中RRP组6 430例,SLRP组3 601例.与RRP相比,SLRP的劣势在于手术时间较长(SMD=1.20,95％ CI0.83～ 1.58),优势在于术中出血少(SMD=-2.02,95％CI-2.67～-1.37),输血率低(RR =0.22,95％CI0.16～0.30),留置导尿时间短(SMD=-1.44,95％CI-2.34～-0.54)和住院时间短(SMD=-0.97,95％CI-1.29～-0.66),差异均有统计学意义(P＜0.05).两种术式的切缘阳性率(RR=0.94,95％CI0.84～1.05)、围手术期并发症(RR =0.78,95％ CI0.60～ 1.02)、术后1年尿失禁情况(RR =0.85,95％CI0.57 ～ 1.28)及勃起功能恢复情况(RR=1.13,95％CI0.97 ～ 1.31)等方面比较差异均无统计学意义(P＞0.05).结论 与RRP相比,SLRP具有出血少、创伤小、术后恢复快等优点,但手术治疗效果无显著性差异,因此,SLRP可能是治疗局限性前列腺癌更好的方法.但仍需开展多中心、大样本的随机对照研究以更好地评估两种手术方式的优劣.
目的 採用薈萃分析的方法比較標準腹腔鏡下根治性前列腺切除術(standard laparoscopic radical prostatectomy,SLRP)與恥骨後根治性前列腺切除術(retropubic radical prostatectomy,RRP)治療跼限性前列腺癌的效果.方法 通過計算機在PubMed、Web of Science、Cochrane Library及EMBASE數據庫(1992年1月至2015年4月)中檢索相關文獻,入選文獻必鬚對比SLRP與RRP的療效,包含手術時間、齣血量、輸血率、留置導尿時間、住院時間、切緣暘性率、圍手術期併髮癥、性功能恢複情況以及尿失禁恢複情況等指標中的至少一項,運用薈萃分析比較兩種手術方式在治療跼限性前列腺癌療效上的差異.結果 經篩選後共17篇文獻納入分析,其中RRP組6 430例,SLRP組3 601例.與RRP相比,SLRP的劣勢在于手術時間較長(SMD=1.20,95％ CI0.83～ 1.58),優勢在于術中齣血少(SMD=-2.02,95％CI-2.67～-1.37),輸血率低(RR =0.22,95％CI0.16～0.30),留置導尿時間短(SMD=-1.44,95％CI-2.34～-0.54)和住院時間短(SMD=-0.97,95％CI-1.29～-0.66),差異均有統計學意義(P＜0.05).兩種術式的切緣暘性率(RR=0.94,95％CI0.84～1.05)、圍手術期併髮癥(RR =0.78,95％ CI0.60～ 1.02)、術後1年尿失禁情況(RR =0.85,95％CI0.57 ～ 1.28)及勃起功能恢複情況(RR=1.13,95％CI0.97 ～ 1.31)等方麵比較差異均無統計學意義(P＞0.05).結論 與RRP相比,SLRP具有齣血少、創傷小、術後恢複快等優點,但手術治療效果無顯著性差異,因此,SLRP可能是治療跼限性前列腺癌更好的方法.但仍需開展多中心、大樣本的隨機對照研究以更好地評估兩種手術方式的優劣.
목적 채용회췌분석적방법비교표준복강경하근치성전렬선절제술(standard laparoscopic radical prostatectomy,SLRP)여치골후근치성전렬선절제술(retropubic radical prostatectomy,RRP)치료국한성전렬선암적효과.방법 통과계산궤재PubMed、Web of Science、Cochrane Library급EMBASE수거고(1992년1월지2015년4월)중검색상관문헌,입선문헌필수대비SLRP여RRP적료효,포함수술시간、출혈량、수혈솔、류치도뇨시간、주원시간、절연양성솔、위수술기병발증、성공능회복정황이급뇨실금회복정황등지표중적지소일항,운용회췌분석비교량충수술방식재치료국한성전렬선암료효상적차이.결과 경사선후공17편문헌납입분석,기중RRP조6 430례,SLRP조3 601례.여RRP상비,SLRP적열세재우수술시간교장(SMD=1.20,95％ CI0.83～ 1.58),우세재우술중출혈소(SMD=-2.02,95％CI-2.67～-1.37),수혈솔저(RR =0.22,95％CI0.16～0.30),류치도뇨시간단(SMD=-1.44,95％CI-2.34～-0.54)화주원시간단(SMD=-0.97,95％CI-1.29～-0.66),차이균유통계학의의(P＜0.05).량충술식적절연양성솔(RR=0.94,95％CI0.84～1.05)、위수술기병발증(RR =0.78,95％ CI0.60～ 1.02)、술후1년뇨실금정황(RR =0.85,95％CI0.57 ～ 1.28)급발기공능회복정황(RR=1.13,95％CI0.97 ～ 1.31)등방면비교차이균무통계학의의(P＞0.05).결론 여RRP상비,SLRP구유출혈소、창상소、술후회복쾌등우점,단수술치료효과무현저성차이,인차,SLRP가능시치료국한성전렬선암경호적방법.단잉수개전다중심、대양본적수궤대조연구이경호지평고량충수술방식적우렬.
Objective To compare the outcomes of standard laparoscopic radical prostatectomy (SLRP) and retropubic radical prostatectomy (RRP) via meta-analysis.Methods A systematic literature search of articles from January 1992 to April 2015 was conducted via Pubmed,Web of Science,Cochrane Library,and EMBASE databases,and the references of the retrieved articles.Fixed-or random-effect models were used to summarize the estimates to evaluate operation time,blood loss,transfusion,catheterization time,hospital stay,surgical margin status,perioperative complications,postoperative erectile dysfunction,and postoperative urinary incontinence in these two approaches.Results A total of 17 articles were included in this study.Compared with RRP group,the operation time was longer in SLRP group (SMD =1.20,95％ CI 0.83,1.58).On the contrary,the SLRP group held advantages in blood loss (SMD =-2.02,95％ CI -2.67,-1.37),transfusion (RR =0.22,95％ CI 0.16,0.30),catheterization time (SMD =-1.44,95 ％ CI-2.34,-0.54),hospital stay (SMD =-0.97,95 ％ CI-1.29,-0.66) (P ＜ 0.05).Moreover,these two approaches showed no difference in surgical margin status (RR =0.94,95 ％ CI 0.84,1.05),perioperative complications (RR =0.78,95％ CI 0.60,1.02),postoperative erectile dysfunction (RR =1.13,95 ％ CI 0.97,1.31),and postoperative urinary incontinence (RR =0.85,95 ％ CI 0.57,1.28) (P ＞0.05).Conclusions Compared with RRP,SLRP could be a more suitable approach to treat localized prostate cancer.Random clinical trials are needed in the future to better evaluate these two approaches.
