中国组织工程研究

中国组织工程研究 ›› 2010, Vol. 14 ›› Issue (53): 10002-10006.doi: 10.3969/j.issn.1673-8225.2010.53.030

• 器官移植循证医学 evidence-based medicine of organ transplantation • 上一篇    下一篇

经腹腹腔镜与后腹膜腹腔镜根治性肾切除治疗肾癌的Meta分析

张卫玮，曹润福   

  1. 南昌大学第一附属医院泌尿外科，江西省南昌市     330006
  • 出版日期:2010-12-31 发布日期:2010-12-31
  • 通讯作者: 曹润福，博士，主任医师，南昌大学第一附属医院泌尿外科，江西省南昌市 330006 cao-r-f@163.com
  • 作者简介:张卫玮★，男，1983年生，江西省南昌市人，汉族，南昌大学医学院在读硕士，医师，主要从事腹腔镜泌尿外科研究。 44969670@qq.com

Transperitoneal laparoscopic versus retroperitioneoscopic radical nephrectomy in renal cell carcinoma: A Meta-analysis

Zhang Wei-wei, Cao Run-fu   

  1. Department of Urology, the First Affiliated Hospital of Nanchang University, Nanchang  330006, Jiangxi Province, China
  • Online:2010-12-31 Published:2010-12-31
  • Contact: Cao Run-fu, Doctor, Chief physician, Department of Urology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China cao-r-f@163.com
  • About author:Zhang Wei-wei★, Studying for master’s degree, Physician, Department of Urology, the First Affiliated Hospital of Nanchang University, Nanchang 330006, Jiangxi Province, China 44969670@qq.com

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445

被引次数

33

摘要：

背景：目前对于经腹腹腔镜与后腹膜腹腔镜根治性肾切除治疗肾癌的效果及安全性存在分歧，从而制约了对其进一步研究。
目的：系统评价经腹腹腔镜肾癌根治术与后腹膜腹腔镜肾癌根治术治疗肾癌的效果。
方法：于2010-01以“腹腔镜肾癌根治术，laparoscopic radical nephrectomy”为关键词，计算机检索Medline，EMbase，Cochrane database，CMB，CNKI截止2009-12-31以前的随机、半随机对照研究文献，利用RevMan4.2.2软件进行了Meta分析。
结果与结论：共筛选出5个前瞻性随机对照研究，Meta分析结果显示，在平均出血量[SMD=-0.22，95%CI(-0.52，0.09)]、术后标本质量[SMD=0.35，95%CI(-0.17，0.86)]方面差异无显著性意义，而在平均手术时间[SMD=0.72，95%CI(0.41，1.03)]、并发症发生率[OR=2.16，95%CI(1.03，4.51)]方面差异有显著性意义。提示经腹腹腔镜肾癌根治术和后腹膜腹腔镜肾癌根治术治疗肾癌在平均出血量及术后标本质量方面无明显差异，后腹膜腹腔镜肾癌根治术的平均手术时间及并发症发生率均低于经腹腹腔镜肾癌根治术。

关键词: 腹腔镜, 根治性肾切除, 肾癌, Meta分析, 系统评价, 随机对照试验

Abstract:

BACKGROUND: It remains controversial in term of the efficacy and safety for the two approaches laparoscopic surgery for treatment of localised renal cell carcinoma limited its further investigation.
OBJECTIVE: To assess the difference of clinical outcomes in the comparative studies evaluating transperitoneal and retroperitoneal approaches for radical nephrectomy.
METHODS: A systematic review of the literature was performed in January 2010, searching Medline, Embase, Cochrane Library, CBM, and CNKI from January 1966 to December 2009. A “random, semi-randomized controlled study of literature” protocol using the term laparoscopic radical nephrectomy was applied. The authors reviewed the records to identify comparative studies. A cumulative analysis was conducted using Review Manager software v.4.2.
RESULTS AND CONCLUSION: We identified 5 prospective randomized controlled studies, meta analysis results showed that, there was no significant difference between transperitoneal laparoscopic radical nephrectomy and retroperitioneoscopic laparoscopic radical nephrectomy in estimated blood loss [SMD=-0.22, 95%CI(-0.52, 0.09)] and specimen weight [SMD=0.35, 95%CI (-0.17, 0.86)], significant difference was existed in operative time [SMD=0.72, 95%CI(0.41, 1.03)] and complication rate [OR=2.16, 95%CI(1.03, 4.51)]. The available data were not sufficient to prove the superiority of any surgical approach in terms of estimated blood loss and specimen weight. Retroperitioneoscopic laparoscopic radical nephrectomy is followed by significantly lower operative time, and complication than transperitoneal laparoscopic radical nephrectomy.

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