摘要
目的系统评价腹腔镜腹股沟疝修补术中应用钉合与免钉合技术的疗效。方法检索截至2010年9月PubMed、EMBASE、CENTREN、中国生物医学文献数据库等中所有关于钉合与免钉合腹腔镜腹股沟疝修补术疗效比较的临床随机对照试验,并辅以手工检索,对检索文献进行质量评价及筛选,采用RevMan5.0软件对最终纳入文献的研究结果进行meta分析。结果共纳入8个随机对照试验,meta分析结果显示,钉合组与免钉合组疝修补术后复发率(RR=1.24,95%CI0.36～4.26,P=0.74)、并发症发生率(RR=1.18,95%CI0.84～1.65,P=0.34)、术后恢复正常活动天数(MD=0.14,95%CI-0.16～0.44,P=0.37)均无差异,但钉合组手术时间长于免钉合组(MD=4.52,95%CI1.46～7.59,P=0.004)且手术费用高,两组患者术后疼痛情况尚不确定。结论钉合与免钉合技术的临床疗效无明显差异,但钉合技术所需手术时间更长,费用更高,术后疼痛仍需更多设计合理的大样本随机对照试验以明确结论。
Objective To conduct a systematic review on the clinical effectiveness and relative efficiency of stapled and unstapled mesh in laparoscopic inguinal hernia repair.Methods PubMed,EMBASE,CENTREN,Cochrane Central Register of Controlled Trials （CENTRAL）,CBMdisk,and National Knowledge Infrastructure（CNKI） database were searched for randomized controlled trials comparing stapled and unstapled mesh in the laparoscopic repair of inguinal hernia; manual search was also conducted.The obtained literatures were rated and eligible trails were subjected to meta-analysis using RevMan5.0 software.Results Eight trials assessing 1,619 participants were finally included.Meta-analysis showed that there were no significant differences between the compared arms in post-operation recurrence rate （RR=1.24,95%CI 0.36-4.26,P=0.74）,total complication （RR=1.18,95% CI 0.84-1.65,P=0.34 ）,time to return to normal activity（MD=0.14,95%CI-0.16-0.44,P=0.37）.The mesh staple group needed more operative time（MD=4.52,95%CI 1.46-7.59,P=0.004）,cost more,and there was no definite conclusion on the post-operative pain in the two groups.Conclusion There is no noticeable difference in the clinical effectiveness between the stapled and unstapled mesh in laparoscopic inguinal hernia repair; the stapled mesh costs more,needs more time; and the post-operative pain still needs to be studied by more well-designed and large sample randomized controlled trials.
出处
《第二军医大学学报》
CAS
CSCD
北大核心
2010年第12期1337-1340,共4页
Academic Journal of Second Military Medical University
基金
广西省卫生厅课题(桂卫Z2009082)~~
关键词
腹股沟疝
修补术
腹腔镜
补片
inguinal hernia； repair； laparoscopes； mesh；
