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目的:系统评价腹腔镜与传统开腹手术治疗国人远端胃癌的有效性和安全性。方法:计算机检索国内外文献数据库(时限均从建库开始至2013年5月),收集腹腔镜与开腹手术治疗国人远端胃癌的随机对照试验,使用RevMan 5.2软件进行Meta分析。结果:最终纳入6个研究,555例患者,其中腹腔镜组278例,开腹组277例。Meta分析结果显示,与开腹组比较,腹腔镜组在术中出血量、术后排气时间、首次进食时间、术后住院时间、切口长度、术后镇痛剂的使用例数、并发症发生率均明显减少(均P<0.05);但手术时间延长、术中淋巴结清扫数目减少(均P<0.05)。结论:腹腔镜远端胃癌根治术围手术期并发症少,患者恢复快,安全可行,但手术时间长,术中淋巴结清扫数目少。
Objective: To systematically evaluate the effectiveness and safety of laparoscopy and conventional laparotomy in the treatment of distal gastric cancer in our country. Methods: The databases of domestic and foreign literatures were retrieved by computer (time limit was from the beginning of construction to May 2013). Randomized controlled trials of laparoscopic and laparotomy for distal gastric cancer in our country were collected. Meta-analysis was performed using RevMan 5.2 software. RESULTS: Six studies were eventually enrolled in 555 patients, including 278 in the laparoscopic group and 277 in the open group. Meta analysis showed that compared with the open group, laparoscopic group in the amount of bleeding, postoperative exhaust time, the first time eating, hospital stay, incision length, the number of cases of postoperative analgesics, complications (All P <0.05). However, the operation time was prolonged and the number of lymph node dissection in operation was decreased (all P <0.05). Conclusions: Perioperative complications of radical laparoscopic radical gastrectomy are few and the patients recover quickly and safely. However, the operation time is long and the number of lymph node dissection in operation is small.