laparoscopic 与开放胃切除术对于晚期胃癌:随机对照试验的元分析
Vinicius Bittar1, Mauricio Ferreira Boneli2, Pedro C Abrahão Reis3
1Centro Universitário das Faculdades Associadas de Ensino, São João da Boa Vista, São Paulo, Brazil. vinibdepontes@gmail.com.
Journal of gastrointestinal cancer
|April 2, 2024
概括
laparoscopy辅助胃切除术 (LAG) 为晚期胃癌 (AGC) 提供了开放胃切除术 (OG) 的安全有效替代方案,具有类似的长期存活率. 然而,LAG可能会增加胰腺的风险.
科学领域:
- 手术瘤学手术瘤学
- 胃肠道手术 胃肠道手术
- 最少侵入性的手术
背景情况:
- laparoscopy辅助胃切除术 (LAG) 是用于早期胃癌的确立方法.
- 对于晚期胃癌 (AGC) 的LAG与开放性胃切除术 (OG) 的疗效和安全性尚未确定.
研究的目的:
- 为了比较LAG与OG在AGC患者中的疗效和安全性.
- 为手术治疗AGC提供基于证据的建议.
主要方法:
- 在PubMed,Embase和Cochrane图书馆系统地搜索相关RCT的文献.
- 聚合风险比率 (RR) 和平均差异 (MD) 的元分析,具有95%的置信区间 (CI).
- 使用R软件与随机效应模型进行的统计分析.
主要成果:
- 分析了9个涉及3827名患者的RCT.
- 地方实验小组表明住院时间更短,血液流失减少,但手术时间更长,胰腺瘤风险更高.
- 在手术后并发症,淋巴结检索,死亡率或长期存活率 (3年和5年) 中没有发现显著差异.
结论:
- laparoscopy辅助胃切除术 (LAG) 是治疗晚期胃癌 (AGC) 的开放胃切除术 (OG) 的潜在有效和安全替代方案.
- 加强对胰腺的警是有必要的与LAG.
- 无论是LAG还是OG,都提供了可比的长期瘤结果.
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