微创及开腹胰十二指肠切除术围术期安全性的Meta分析

Meta-analysis of peri-operative safety of minimally invasive and open pancreaticoduodenectomy

  • 摘要: 目的 系统评价微创及开腹胰十二指肠切除术的围术期安全性。 方法 以Cochrane系统评价方法,计算机检索CNKI、万方、PubMed数据库,检索时间1990年1月- 2014年12月,收集微创胰十二指肠切除术和传统开腹手术围术期安全性的对比研究。采用软件Rev Man 5.0对数据进行Meta分析。 结果 共纳入7个临床试验,557例患者。微创组与开腹组手术时间、术中出血量及住院时间的差异有统计学意义(P< 0.05),而术后胰瘘发生率、胃排空障碍发生率和术后死亡率的差异无统计学意义(P> 0.05)。 结论 微创胰十二指肠切除术与传统开腹手术同样安全可行,微创手术具有术中出血少、疼痛轻、恢复快、住院时间短等优点,有良好的发展前景。

     

    Abstract: Objective To evaluate the safety of minimally invasive surgery and open surgery on the prognosis of pancreaticoduodenectomy. Methods Database including CNKI, WanFang and PubMed (from January 1990 to December 2014) were searched to collect articles on comparing the safety of minimally invasive pancreaticoduodenectomy with open pancreaticoduodenectomy. The Cochrane network RevMan 5.0 software was used for Meta - analysis. Results A total of 7 articles with 557 patients were included. The Meta-analysis showed significant differences in operative time, estimated blood loss and length of hospital stays between minimally invasive pancreaticoduodenectomy group and open pancreaticoduodenectomy group (P< 0.05). There was no significant difference in pancreatic fistula, delayed gastric empty and mortality between two groups (P> 0.05). Conclusion Minimally invasive pancreaticoduodenectomy is as safe and feasible as open pancreaticoduodenectomy, and it has the advantages of less bleeding, milder pain, faster recovery and shorter hospital stay.

     

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