论文部分内容阅读
目的探讨腹腔镜去顶术与穿刺术治疗肾囊肿的安全性和有效性。方法计算机检索Pub Med、Cochrane、EMbase、CNKI、万方和维普数据库,查找所有比较腹腔镜去顶术和穿刺术治疗肾囊肿的随机对照试验,检索时限均为建库到2011年12月31日,同时手检纳入文献的参考文献,按纳入排除标准由2人独立进行随机临床试验(RCT)的筛选、资料提取和质量评价后,采用RevMan 5.0软件进行Meta分析。结果共纳入9个研究,共702例患者。Meta分析结果显示,在手术时间和并发症方面,腹腔镜去顶术与穿刺术差异均无统计学意义(P>0.05)。与穿刺术相比,腹腔镜去顶术的术后住院时间较长[WMD=-3.40,95%CI(-3.57,-3.23),P<0.01],复发率较低[OR=19.88,95%CI(8.62,45.85),P<0.01],费用较高[SMD=-5.75,95%CI(-7.58,-3.92),P<0.01]。结论腹腔镜去顶术与穿刺术2种术式相比,安全性方面相似,虽然腹腔镜去顶术的费用更高,术后住院时间较长,但复发率低于穿刺术。
Objective To investigate the safety and effectiveness of laparoscopic debridement and puncture in the treatment of renal cysts. Methods We searched PubMed, Cochrane, EMbase, CNKI, Wanfang and VIP databases for all randomized controlled trials comparing laparoscopic debriquetting and puncture in the treatment of renal cysts. The search time was from December 31, 2011 At the same time, the references of hand-checking were included in the literature. According to the exclusion criteria, randomized clinical trial (RCT) screening, data extraction and quality evaluation were conducted independently by 2 people. Meta-analysis was performed by using RevMan 5.0 software. Results A total of 9 studies were included, 702 patients in total. Meta-analysis showed no significant difference in laparoscopic debridement and puncture in operative time and complications (P> 0.05). Compared with the puncture, laparoscopic surgery after a long hospital stay longer [WMD = -3.40,95% CI (-3.57, -3.23, P <0.01], the recurrence rate was low [OR = 19.88,95 % CI (8.62,45.85), P <0.01], higher cost [SMD = -5.75,95% CI (-7.58, -3.92), P <0.01]. Conclusions Laparoscopic surgery is similar in safety to the two procedures of puncture. Although the cost of laparoscopic debridement is higher and the postoperative hospital stay is longer, the recurrence rate is lower than that of puncture.