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目的:系统评价腹腔镜肝切除术(LLR)与开腹肝切除术(OLR)治疗肝癌的近、远期疗效和安全性。方法:检索相关期刊、资料、会议文献和学位论文数据库,收集比较LLR与OLR治疗肝癌疗效的病例-对照研究。按MOOSE规范对纳入研究进行分析,提取数据并用Rev Man 5.3软件对数据进行Meta分析。结果:最终共纳入15篇病例-对照研究,共1 246例患者,LLR组499例,OLR组747例。Meta分析结果显示,LLR组与OLR组的手术时间,1、3、5年生存率,1、3、5年无瘤生存率,3年肿瘤复发率组间差异均无统计学意义(均P>0.05);LLR与OLR相比术中出血量少、术后并发症发生率低、围手术期死亡率低、术后住院天数少(均P<0.05)。结论:LLR可以达到与OLR同样的根治效果,两者近、远期疗效无明显差异,且LLR围手术期不良事件少于OLR。
Objective: To systematically evaluate the short-term and long-term efficacy and safety of laparoscopic liver resection (LLR) versus open laparotomy (OLR) in the treatment of liver cancer. Methods: The related journals, data, conference literature and dissertation database were searched and a case-control study comparing the efficacy of LLR and OLR in the treatment of liver cancer was collected. The inclusion studies were analyzed according to MOOSE specifications, data were extracted and Meta-analysis of data was performed using RevMan 5.3 software. RESULTS: A total of 15 case-control studies were included, with a total of 1 246 cases, 499 in the LLR group and 747 in the OLR group. The results of Meta analysis showed that there was no significant difference between the two groups in the operation time, 1,3,5-year survival rate, 1,3,5-year disease-free survival rate and 3-year tumor recurrence rate in LLR group and OLR group > 0.05). Compared with OLR, LLR had less intraoperative blood loss, less postoperative complication, less perioperative mortality and less postoperative hospital stay (all P <0.05). Conclusion: LLR can achieve the same curative effect as OLR. There is no significant difference between the two methods in long-term and short-term effects, and there are fewer perioperative adverse events in LLR than those in OLR.