發(fā)布時(shí)間：2018-09-07 21:48

【摘要】：目的:肥胖因素對(duì)腹腔鏡腎癌根治術(shù)手術(shù)的安全性與可行性的影響一直存在爭議,本研究將系統(tǒng)評(píng)價(jià)肥胖因素對(duì)腹腔鏡腎癌根治術(shù)療效的影響。方法:檢索PubMed,Web of Science,Embase,Cochrane Library,Wiley Online Library,SpringerLink,Elsevier,EBSCO,and Ovid等9個(gè)外文數(shù)據(jù)庫,檢索時(shí)間為自建庫至2017年2月,搜索有關(guān)肥胖因素對(duì)腹腔鏡腎癌根治術(shù)影響的隨機(jī)或非隨機(jī)對(duì)照試驗(yàn)文獻(xiàn),并篩檢納入文獻(xiàn)的參考文獻(xiàn),嚴(yán)格按照PRISMA原則篩選后,評(píng)估文獻(xiàn)質(zhì)量并提取相關(guān)數(shù)據(jù)資料,采用Review Manager 5.3軟件進(jìn)行系統(tǒng)評(píng)價(jià)。結(jié)果:最終納入9篇文獻(xiàn)進(jìn)行研究,其中5篇來自美國、4篇來自亞洲,均為回顧性研究的非隨機(jī)對(duì)照試驗(yàn)文獻(xiàn)。總共納入1039例參與研究,其中肥胖組365例,非肥胖組674例。Meta分析結(jié)果發(fā)現(xiàn):(1)肥胖組較非肥胖組手術(shù)時(shí)間明顯延長(歐美p0.00001,WMD:49.21 min,95%CI:35.97 to 62.45;亞洲p0.00001,WMD:26.94 min,95%CI:19.04 to 34.85;overall WMD:32.80 min,95%CI:26.01 to 39.58,p0.00001)及術(shù)中出血量顯著增多(歐美p=0.03,WMD:34.02 ml,95%CI:3.95 to 64.09;亞洲p0.00001,WMD:49.61 ml,95%CI:42.32 to 56.91;overall WMD:48.75 ml,95%CI:41.66 to 55.83,p0.00001);(2)肥胖組術(shù)中輸血率(歐美p=0.27,亞洲p=0.27),住院時(shí)間(歐美p=0.37,亞洲p=0.87),中轉(zhuǎn)開放率(歐美p=0.27,亞洲p=0.11),并發(fā)癥(嚴(yán)重并發(fā)癥p=0.97,非嚴(yán)重并發(fā)癥p=0.54),初次進(jìn)食流汁時(shí)間(歐美p=0.94,亞洲p=0.72),初次下床活動(dòng)時(shí)間(歐美p=0.14,亞洲p=0.42)差異無統(tǒng)計(jì)學(xué)意義。結(jié)論:對(duì)于肥胖患者而言,盡管腹腔鏡腎癌根治術(shù)手術(shù)時(shí)間較長、術(shù)中出血量偏多,但依然是安全可行的。
[Abstract]:Objective: the influence of obesity factors on the safety and feasibility of laparoscopic radical renal cell carcinoma surgery has been controversial. Methods: nine foreign language databases, including PubMed,Web of Science,Embase,Cochrane Library,Wiley Online Library,SpringerLink,Elsevier,EBSCO,and Ovid, were searched for random or non-randomized controlled trials on the effects of obesity factors on laparoscopic radical renal cell carcinoma surgery until February 2017. The references included in the literature were screened strictly according to the PRISMA principle, the quality of the literature was evaluated and the relevant data were extracted, and the systematic evaluation was carried out with the software of Review Manager 5.3. Results: nine articles were included in the study, of which 5 were from the United States and 4 were from Asia, all of which were non-randomized controlled trial literatures of retrospective study. A total of 1039 subjects were enrolled in the study. 闈炶偉鑳栫粍674渚，

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