腹腔镜与开腹全直肠系膜切除术后吻合口漏发生率的meta分析

摘要

目的 探讨腹腔镜与开腹全直肠系膜切除术后吻合口漏发生率是否存在差异.方法 计算机检索Pubmed、Springer、Conchrane图书馆、万方全文数据库、中国知网全文数据库,筛选比较腹腔镜与开放全直肠系膜切除术后吻合口漏发生率的随机对照研究(RCT)和临床对照研究(CCT).从文献提取数据,采用RevMan5.1.7软件进行统计学分析.结果 共纳入6篇RCT 967例和23篇CCT 3106例直肠癌.腹腔镜与开放全直肠系膜切除术后吻合口漏发生率无统计学差异(RCT:RR=0.72,95％ CI:0.37 ～ 1.37;CCT:OR=0.81,95％ CI:0.61～1.08).结论 腹腔镜全直肠系膜切除术不会增加术后吻合口漏的风险.%Objective To explore the differences in the incidence of postoperative anastomotic leakage of laparoscopic and open total mesorectal excision (TME) for rectal cancer.Methods The randomized controlled trials (RCT) and controlled clinical trials (CCT) on the incidence of postoperative anastomotic leakage between laparoscopic and open total mesorectal excision for rectal cancer were collected by searching Pubmed,Springer,Conchrane Library,Wanfang database and CNKI.Data were extracted from these trials and data analysis was performed by RevMan 5.1.7.Results Six RCT of 967 cases and 23 CCT of 3106 cases were included.Analyses showed that the incidence of postoperative anastomotic leakage of laparoscopic and open total mesorectal excision for rectal cancer had no statistical significance (RR =0.72,95％ CI:0.37-1.37 for RCT; OR =0.81,95％ CI:0.61-1.08 for CCT).Conclusion Laparoscopic TME does not increase the incidence of postoperative anastomotic leakage.