微创及传统开放食管癌根治术疗效分析及远期随访结果的Meta分析

目的 系统评价微创食管癌根治术(MIE)与传统的开放手术(Open)在治疗食管癌围术期并发症及长期随访结果中生存率的差异.方法 检索Embase、Pubmed、Cohorane评价员、Medline、万方、知网,收集到相关的研究,根据Coehrane评价员手册5.0筛选文献、提取资料、评价文献质量,使用Stata11.0软件进行Meta分析.结果 本研究纳入20篇非随机对照研究,总样本量3 568例(MIE组1 859例,Open组1 709例),合并结果显示微创组手术时间、住院时间更短,术中出血量更少,术中清扫淋巴结的数目更多(P＜0.05),围术期总的并发症较少,呼吸系统、循环系统并发症及围术期病死率均较低,差异有统计学意义(P＜0.05).但两组术后重症监护病房(ICU)停留时间、围术期消化系统及外科技术相关并发症、吻合口瘘的发生率、3年生存情况差异均无统计学意义(P>0.05).结论 微创手术在治疗食管癌中是可行的,并且围术期相关并发症发生率较传统手术低.

Effect analysis of minimally invasive esophagectomy versus traditional open radical resectionfor esophageal cancer and long-term follow up results:a meta-analysis

Objective To systematically evaluate the survival rate difference between minimally invasive surgery(MIE)and traditional open surgery(Open)in treating esophageal cancer perioperative complications and long-term follow-up.Methods Embase,Pubmed,Cohorane library search,Medline,Wanfang and HowNet were retrieved,and the related researches were collected.The literatures screening,data extraction and literature quality evaluation were conducted according to the 5.0 Coehrane reviewers manual.Then the meta analysis was conducted by using the Stata11.0 software.Results This study included 20 non-randomized control trials,with a total sample size of 3 568 cases(1 859 cases in the MIE group and 1 709 cases in the Open group),the pooled results showed that the MIE group had shorter operative time,shorter hospital stay,less intraoperative blood loss and more intraoperative lymph nodes clearing(P＜0.05),and perioperative complications,respiratory system complications,circulatory system complications and perioperative mortality rates were lower(P＜0.05).But postoperative ICU stay time,perioperative complications of digestive system and surgery-related complications,incidence of anastomotic fistula and 3-year survival had no statistically significant differences between the two groups(P>0.05).Conclusion MIE surgery is feasible in the treatment of esophageal cancer,and has lower incidence of perioperative complication compared with traditional surgery.