CAJ | 학술논문

目的：评价体质指数（BMI）在腹腔镜胃癌根治术中对患者术后短期结局的影响。方法计算机检索PubMed、EMBASE、万方数据库、CNKI和中国生物医学文献数据库（CBM），2014年10月前发表的有关高BMI与低BMI胃癌患者行腹腔镜胃癌根治术的文献，采用RevMan 5．2软件对所纳入的数据进行荟萃分析，应用Stata 12．0统计软件进行Begg及Egger检验以评估纳入文献的发表偏倚。结果12项回顾性队列研究共计4798例患者纳入分析，其中高BMI组1215例，低BMI组3583例。 Meta分析结果显示：与低BMI组相比，高BMI组患者手术时间延长（SMD＝0．64，95％CI：0．35～0．93，P＝0．000），失血量较多（SMD＝0．63，95％CI：0．24～1．03，P＝0．002），清扫淋巴结数量较少（SMD＝－0．44，95％CI：－0．72～－0．17，P＝0．002）、术后总并发症发生率较高（OR＝1．44，95％CI：1．19～1．74， P＝0．000）；两组间住院时间、术后恢复排气时间及分项比较并发症发生情况的差异无统计学意义（均P＞0．05）。结论高BMI会导致腹腔镜胃癌根治术手术时间延长，术中出血量增加，术后并发症发生风险增大。
목적：평개체질지수（BMI）재복강경위암근치술중대환자술후단기결국적영향。방법계산궤검색PubMed、EMBASE、만방수거고、CNKI화중국생물의학문헌수거고（CBM），2014년10월전발표적유관고BMI여저BMI위암환자행복강경위암근치술적문헌，채용RevMan 5．2연건대소납입적수거진행회췌분석，응용Stata 12．0통계연건진행Begg급Egger검험이평고납입문헌적발표편의。결과12항회고성대렬연구공계4798례환자납입분석，기중고BMI조1215례，저BMI조3583례。 Meta분석결과현시：여저BMI조상비，고BMI조환자수술시간연장（SMD＝0．64，95％CI：0．35～0．93，P＝0．000），실혈량교다（SMD＝0．63，95％CI：0．24～1．03，P＝0．002），청소림파결수량교소（SMD＝－0．44，95％CI：－0．72～－0．17，P＝0．002）、술후총병발증발생솔교고（OR＝1．44，95％CI：1．19～1．74， P＝0．000）；량조간주원시간、술후회복배기시간급분항비교병발증발생정황적차이무통계학의의（균P＞0．05）。결론고BMI회도치복강경위암근치술수술시간연장，술중출혈량증가，술후병발증발생풍험증대。
Objective To evaluate the effect of body mass index (BMI) on postoperative short-term outcomes of laparoscopy radical gastrectomy by meta-analysis. Methods A literature search was performed in PubMed, EMBASE, Cochrane Library databases, CNKI, and CBM, Wanfang database to screen clinical trials published before October 2014 that compared short-term outcomes between high BMI and low BMI patients undergoing laparoscopy radical gastrectomy. RevMan 5.2 was used to perform the meta-analysis. Begg′s and Egger′s tests were carried out with Stata 12.0 software to evaluate the publication bias of enrolled literatures. Results Twelve studies involved a total of 4798 gastric cancer patients after laparoscopy radical gastrectomy. There were 1215 patients in high BMI group (BMI≥25 kg/m2) and 3583 patients in the low BMI group (BMI <25 kg/m2). Compared with the low BMI group, the high BMI group were associated with longer operation time (SMD=0.64, 95%CI:0.35-0.93, P=0.000), more intraoperative blood loss (SMD=0.63, 95%CI:0.24-1.03, P=0.002), less retrieved lymph nodes (SMD=-0.44, 95%CI:-0.72--0.17, P=0.002), and more postoperative complications (OR=1.44, 95%CI:1.19-1.74, P=0.000). There were no significant differences in postoperative hospital stay, the time to first flatus and initial complication (P>0.05). Conclusion The higher BMI may result in a longer operation time, more intraoperative blood loss and a higher rate of postoperative complication after laparoscopy radical gastrectomy.