腹腔镜下宫颈癌根治术治疗早期宫颈癌的Meta分析被引量：13

Efficacy and Prognosis of Laparoscopic Radical Hysterectomy for Early Stage Cervical Cancer:A Meta-Analysis

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摘要目的评价腹腔镜下根治全子宫切除+腹膜后淋巴清扫术治疗早期宫颈癌的疗效及预后影响。方法电子检索Cochrane图书馆,MEDLINE、EMBASE、PubMed、CBMdisc数据库,收集符合纳入标准的文献,提取资料,评价纳入研究的方法学质量,并提取有效数据进行Meta分析。结果符合纳入标准的文章8篇,无前瞻性随机对照研究,3篇为前瞻性非随机对照试验,5篇为回顾性病例对照研究,与传统的开腹宫颈癌根治术相比,腹腔镜下根治全子宫切除+腹膜后淋巴清扫术具有术中出血量少、住院时间短、术后肠道排气时间短、术后并发症少等优点,而在复发率和术中并发症发生率上则无显著差异。结论腹腔镜下根治性子宫切除术+盆腔淋巴结切除术是安全可行的,它能缩短住院时间,减少术中出血量,降低术后并发症的发生率,不增加手术后的复发率和术中并发症发生率。但由于纳入的文献的质量较低,这将会影响结果的可靠性。需要大样本的随机双盲对照试验的研究结果来进一步证实。 Objective To evaluate the clinical effect on the treatment and the prognosis of laparoscopic radical hystereetomy（LRH） and pelvic lymphadenectomy（LPL） for patient with early cervical cancer. Methods The following electronic databases were searched： CBMdisc, MEDLINE, PubMed, EMBASE and Cochrane Library. All eligible literatures were assessed for quality. All data were performed by a meta-analysis. Results There were 8 literatures that met the inclusion criteria, including three prospective non-randomized controlled trials and five retrospective case- control studies, but with no RCTs. Comparing with abdominal radical hysterectomy （ARH）＋ abdominal pelvic lymphadenectomy （APL）, LRH＋LPL had several advantages, such as decreasing the recovery time of bowel, the blood loss during operation, postoperative hospital stays and complications of postoperation. But there was no difference in the recurrence rate and complications of intraoperation between LRH＋LPL and ARH＋APL. Conclusion LRH＋LPL is a safe and effective alternative to conventional abdominal surgery for stage Ⅰ b- Ⅱ a cervical cancer. Because the quality of all the included literatures is low, the conclusion is needed to be further assessed by rigorously designed and randomized double-blind controlled trials.

作者陈艳丽李力

机构地区广西医科大学第四附属医院暨柳州市工人医院广西医科大学附属肿瘤医院妇瘤科

出处《循证医学》 CSCD 2012年第5期307-313,共7页 The Journal of Evidence-Based Medicine

关键词宫颈癌腹腔镜下根治性子宫切除术循证医学 META分析 cervical cancer laparoscopy radical hysterectomy evidence-based medicine meta-analysis

分类号 R737.33 [医药卫生—肿瘤]

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