發(fā)布時間：2018-09-07 21:48

【摘要】：目的:肥胖因素對腹腔鏡腎癌根治術手術的安全性與可行性的影響一直存在爭議,本研究將系統(tǒng)評價肥胖因素對腹腔鏡腎癌根治術療效的影響。方法:檢索PubMed,Web of Science,Embase,Cochrane Library,Wiley Online Library,SpringerLink,Elsevier,EBSCO,and Ovid等9個外文數(shù)據(jù)庫,檢索時間為自建庫至2017年2月,搜索有關肥胖因素對腹腔鏡腎癌根治術影響的隨機或非隨機對照試驗文獻,并篩檢納入文獻的參考文獻,嚴格按照PRISMA原則篩選后,評估文獻質(zhì)量并提取相關數(shù)據(jù)資料,采用Review Manager 5.3軟件進行系統(tǒng)評價。結果:最終納入9篇文獻進行研究,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對照試驗文獻。總共納入1039例參與研究,其中肥胖組365例,非肥胖組674例。Meta分析結果發(fā)現(xiàn):(1)肥胖組較非肥胖組手術時間明顯延長(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)肥胖組術中輸血率(歐美p=0.27,亞洲p=0.27),住院時間(歐美p=0.37,亞洲p=0.87),中轉開放率(歐美p=0.27,亞洲p=0.11),并發(fā)癥(嚴重并發(fā)癥p=0.97,非嚴重并發(fā)癥p=0.54),初次進食流汁時間(歐美p=0.94,亞洲p=0.72),初次下床活動時間(歐美p=0.14,亞洲p=0.42)差異無統(tǒng)計學意義。結論:對于肥胖患者而言,盡管腹腔鏡腎癌根治術手術時間較長、術中出血量偏多,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，

本文編號：2229513