■随着技术和医疗的进步,腹腔镜越来越多地用于肝囊肿手术。希望通过分析腹腔镜肝切除术与开腹肝切除术在巨大肝囊肿手术中的安全性和有效性,为临床医师选择治疗手段提供理论依据。
■通过搜索CNKI(中国国家知识基础设施),万方,VIP(中国科技期刊数据库),CBM(中国生物医药光盘),PubMed,Embase和Cochrane图书馆数据库,所有关于腹腔镜肝切除术和开腹肝切除术治疗肝囊肿的安全性和有效性的中文和英文文章均收集自数据库建立至2021年12月.使用EndnoteX9软件进行数据检查和筛选。采用Stata15.1软件对相关数据进行分析。敏感性分析用于评估异质性,漏斗图用于检测结果中的偏倚。
■共纳入43项相关研究,涵盖3,375例肝囊肿患者:腹腔镜肝切除术组1,733例,开腹肝切除术组1,642例。Meta分析显示腹腔镜肝切除组手术时间较短[标准均差(SMD)=-2.27,95%可信区间(CI):-2.63~-1.92,P<0.001],术中出血量少(SMD=-3.62,95%CI:-4.22至-3.02,P<0.001),住院时间较短(SMD=-2.09,95%CI:-2.41至-1.78,P<0.001),术后胃肠功能恢复快(SMD=-3.94,95%CI:-4.68~-3.20,P<0.001),术后并发症少[比值比(OR)=0.45,95%CI:0.35~0.58,P<0.001]具有显著的统计学差异。敏感性分析主要集中,结果具有较高的稳定性。漏斗图是左右对称的。说明干预组效果优于对照组,结果可靠。
■与开腹肝切除术相比,腹腔镜肝切除术的安全性和有效性存在显着差异。可以选择腹腔镜肝切除术以减轻术后疼痛。很少有外国研究包括在内,因此,我们的结果是否适用于欧洲和美国人群仍需进一步研究。
UNASSIGNED: With advances in technology and medical treatment, laparoscopy is increasingly used in hepatic cyst surgery. We hope that the analysis the safety and efficacy of laparoscopic hepatectomy versus open hepatectomy in giant hepatic cyst surgery will provide a theoretical basis for the choice of treatment means for clinicians.
UNASSIGNED: By searching CNKI (
China National Knowledge Infrastructure), Wanfang, VIP (
China Science and Technology Journal Database), CBM (
China Biology Medicine disc), PubMed, Embase and Cochrane Library databases, all Chinese- and English-language articles on the safety and efficacy of laparoscopic hepatectomy and open hepatectomy for hepatic cysts were collected from database establishment to December 2021. Endnote X9 software was used for data checking and screening. Stata 15.1 software was used to analyze the relevant data. Sensitivity analysis was used to assess heterogeneity and funnel plots were used to detect bias in the results.
UNASSIGNED: A total of 43 relevant studies covering 3,375 patients with hepatic cysts were included: 1,733 patients in the laparoscopic hepatectomy group and 1,642 in the open hepatectomy group. Meta-analysis showed that the laparoscopic hepatectomy group had shorter operation time [standard mean difference (SMD) =-2.27, 95% confidence interval (CI): -2.63 to -1.92, P<0.001], less intraoperative blood loss (SMD =-3.62, 95% CI: -4.22 to -3.02, P<0.001), shorter hospital stay (SMD =-2.09, 95% CI: -2.41 to -1.78, P<0.001), faster postoperative gastrointestinal function recovery (SMD =-3.94, 95% CI: -4.68 to -3.20, P<0.001), and less postoperative complications [odds ratio (OR) =0.45, 95% CI: 0.35 to 0.58, P<0.001] than the open hepatectomy group, with significant statistical differences. Sensitivity analyses were largely centered, and it indicates that the results have a high stability. The funnel plot was left-right symmetrical. It indicates that the intervention group was better than the control group and the results were reliable.
UNASSIGNED: There are significant differences in the safety and efficacy of laparoscopic hepatectomy compared with open hepatectomy. Laparoscopic hepatectomy can be selected to reduce postoperative pain. There were few foreign studies included, so whether our results apply to European and American populations still needs further study.