经脐单孔与传统腹腔镜胆囊切除术随机对照试验的Meta分析

被引：15

作者：

何彦安 ^{[1
]}

雷正明 ^{[2
]}

丁辉 ^{[1
]}

叶明新 ^{[2
]}

文亚兰 ^{[1
]}

机构：

[1] 江油市人民医院肝胆外科

[2] 泸州医学院附属医院肝胆外科

来源：

中华肝胆外科杂志 | 2013年 / 02期

关键词：

胆囊切除术,腹腔镜; Meta分析; 随机对照试验;

D O I：

暂无

中图分类号：

R657.4 [胆囊、胆管];

学科分类号：

100408 [卫生政策与卫生管理学];

摘要：

目的评价经脐单孔和传统腹腔镜胆囊切除术的安全性和疗效。方法电子检索1997年1月至2012年4月的PubMde数据库、EMBASE、the Cochrane Controlled Trials Register、中国生物医学文献数据库。纳入比较经脐单孔与传统行腹腔镜胆囊切除术,并观察两组术中中转、术中出血、手术时间、术后并发症、切口满意度、术后疼痛和住院时间的随机对照研究。由两名评价员独立收集数据并对所得数据及试验质量进行评价,采用Cochrane协作网专用软件RevMan5.1版进行统计分析。结果共有12项试验、892例患者符合纳入标准。Meta分析结果提示:与传统腹腔镜胆囊切除术相比,经脐单孔腹腔镜胆囊切除术在术中中转(OR=0.70,95%CI:0.13～3.77,P=0.68)、术后并发症(OR=1.13,95%CI:0.72～1.78,P=0.59)和术后疼痛(WMD=-0.18,95%CI:-0.78～-0.43,P=0.57)方面差异无统计学意义。而在术中出血(WMD=1.43,95%CI:0.09～2.78,P<0.05)、手术时间(WMD=16.79,95%CI:9.05～24.52,P<0.01)、切口满意度(WMD=1.28,95%CI:1.09～1.47,P<0.01)和住院天数(WMD=-0.30,95%CI:-0.58～-0.02,P<0.05)方面,差异均有统计学意义。结论分析显示,经脐单孔电视腹腔镜相比于传统多孔电视腹腔镜胆囊切除术,虽然术中出血增多、手术时间延长,但具有术后切口满意度高、恢复快的优点。

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