腹腔镜与开腹开窗术治疗肝囊肿疗效Meta分析

Comparison of laparoscopic and open fenestration in treatment of hepatic cyst: a meta-analysis

摘要:

目的比较腹腔镜开窗术（LF）与开腹开窗术（OF）在肝囊肿手术中的疗效。方法计算机检索中国知网（CNKI）、万方数据、中国生物医学文献库（CBM）、PubMed 及Embase 等数据库，收集所有LF 与OF 治疗肝囊肿的国内外文献，检索时限均从建库至2017年1 月。采用RevMan 5.3软件进行Meta分析。结果33篇文献符合纳入标准,共2 246例肝囊肿患者。其中，LF组1 145例，OF组1 101例。Meta分析结果显示，LF 组较OF组手术时间短，术中出血量少，住院时间短，术后胃肠功能恢复早，术后并发症少。结论中国人群腹腔镜开窗术治疗肝囊肿的临床效果优于开腹开窗术，腹腔镜手术治疗肝囊肿值得临床推广，但由于纳入英文文献较少，对于欧美人群，LF治疗肝囊肿是否同样具有疗效，仍值得进一步研究证实。

Abstract:

Objective To compare the efficacy of laparoscopic fenestration (LF) and open fenestration (OF) in treatment of hepatic cyst from the perspective of evidence-based medicine. Methods Databases from CNKI,WanFang, CBM, PubMed and EMbase were collected, which were about LF versus OF in the treatment of hepatic cyst from inception to January 2017. Meta analysis was performed with RevMan 5.3 software. Results A total of 33 literatures involving 2,246 patients with hepatic cyst were included, among which were 1,145 cases in LF group and 1,101 cases in OF group. Meta analysis showed that LF group had shorter operative time, less intraoperative blood loss, shorter hospital stay, earlier recovery of gastrointestinal function and less postoperative complications, the differences were statistically significant (P < 0.05). Conclusions The clinical efficacy of LF in the treatment of liver cyst is superior to that of OF. Laparoscopic surgery is worthy of clinical promotion.However, due to the lack of English literatures, further studies are needed to confirm whether the treatment of liver cysts by LF has a significant effect or not in Europe and the United States.