针对局部晚期肺癌的微创手术与胸切除术:系统性审查和元分析
Yuanfa Chen1, Cheng Chen1, Dan Ran2
1Department of Thoracic Surgery, Peng Zhou People's Hospital, Chengdu, Sichuan, China.
Medicine
|January 21, 2026
概括
与开放胸切除术相比,微创手术 (MIS) 为局部晚期肺癌提供更短的手术时间和住院时间. 然而,关键的结果,如失血和并发症,在两种方法之间没有显著差异.
科学领域:
- 胸部外科手术 胸部外科手术
- 手术瘤学手术瘤学
- 最少侵入性手术的方法
背景情况:
- 局部晚期肺癌 (LALC) 通常被认为是微创手术 (MIS) 的禁忌.
- 对LALC的MIS与开放胸切除术的比较结果缺乏足够的研究.
研究的目的:
- 系统地比较微创手术方法 (机器人手术,腹腔镜手术) 与局部晚期肺癌的常规开放胸切除术的结果.
- 综合现有临床研究的证据,以告知治疗决策.
主要方法:
- 在Embase,Cochrane图书馆,PubMed,MEDLINE和科学网络上进行系统的文献搜索.
- 聚合标准平均值差异和相对风险的元分析,使用95%的置信区间.
- 该研究协议已注册在PROSPERO (CRD42024526598) 上.
主要成果:
- 分析了15篇文章,涉及7819名参与者.
- 与开放式胸腔切除相比,微创手术 (MIS) 显示了显著缩短的手术时间 (SMD=0.13) 和减少的住院时间 (SMD=-0.19).
- 在血液流失,ICU日,胸管持续时间,淋巴结产量,并发症,ARDS或复发率方面没有发现显著差异.
结论:
- 在LALC患者的手术时间和住院时间方面,MIS提供了显著的好处.
- 在主要的术后结果或瘤结果中没有观察到统计学上显著的差异.
- 进一步高质量的研究是有必要的,以巩固这些发现.
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