摘要
目的:分析新辅助化疗联合腹腔镜手术治疗结直肠癌的临床疗效。方法:检索中国知网、万方、PubMed、NCBI等数据库自建库至2023年12月收录的关于新辅助化疗联合腹腔镜手术对比单纯手术治疗结直肠癌的对照研究文献。由两名研究人员独立收集文献内容并提取研究数据,应用RevMan 5.4软件进行数据分析。结果:共纳入9项回顾性分析、850例结直肠癌患者,其中436例仅行单纯手术(手术组),414例行新辅助化疗联合腹腔镜手术(联合组)。与手术组相比,联合组术后排气时间短(MD=0.75,95%CI=0.40~1.10,P<0.0001),住院时间短(MD=2.87,95%CI=0.69~5.04,P=0.010),并发症发生率低(OR=4.43,95%CI=2.76~7.11,P<0.00001),复发率低(OR=4.52,95%CI=2.53~8.08,P<0.00001),术后癌胚抗原(MD=2.06,95%CI=0.63~3.49,P=0.005)、CA19-9(MD=14.54,95%CI=4.12~24.96,P=0.006)、CA724(MD=0.92,95%CI=0.57~1.27,P<0.00001)水平低,术后2年生存率高(OR=3.09,95%CI=1.25~7.61,P=0.01),两组手术时间差异无统计学意义(MD=6.13,95%CI=-17.42~29.68,P=0.61)。结论:新辅助化疗联合腹腔镜手术治疗结直肠癌安全、可靠,疗效较好,能有效降低血清癌胚抗原、CA19-9、CA724水平,值得临床推广应用。
Objective:To evaluate the clinical efficacy of neoadjuvant chemotherapy combined with laparoscopic surgery in the treatment of colorectal cancer through a meta-analysis.Methods:The China national knowledge infrastructure,Wanfang,PubMed,and national center for biotechnology information were searched for controlled studies comparing neoadjuvant chemotherapy combined with laparoscopic surgery versus surgery alone for colorectal cancer,published up to Dec.2023.Two researchers independently collected literature content and extracted research data.Data analysis was performed using RevMan 5.4 software.Results:A total of 9 retrospective studies involving 850 patients with colorectal cancer were included,with 436 patients in the surgery alone(SG)group and 414 patients in the neoadjuvant chemotherapy combined with laparoscopic operation(CB)group.Compared with the SG group,the CB group had significantly shorter time to first flatus(MD=0.75,95%CI=0.40~1.10,P<0.0001),shorter hospital stay(MD=2.87,95%CI=0.69~5.04,P=0.010),lower incidence of complications(OR=4.43,95%CI=2.76~7.11,P<0.00001),and lower recurrence rate(OR=4.52,95%CI=2.53~8.08,P<0.00001).The postoperative levels of carcinoembryonic antigen(MD=2.06,95%CI=0.63~3.49,P=0.005),CA19-9(MD=14.54,95%CI=4.12~24.96,P=0.006),and CA724(MD=0.92,95%CI=0.57~1.27,P<0.00001)were significantly lower in the CB group.The 2-year survival rate in the CB group was higher than that in the SG group(OR=3.09,95%CI=1.25~7.61,P=0.01).There was no significant difference in operative time between the two groups(MD=6.13,95%CI=-17.42~29.68,P=0.61).Conclusions:Neoadjuvant chemotherapy combined with laparoscopic surgery is safe,reliable and effective for colorectal cancer,significantly reducing serum carcinoembryonic antigen,CA19-9 and CA724 levels,and is worthy of clinical promotion and application.
作者
杨劭卿
武慧铭
韩振国
YANG Shaoqing;WU Huiming;HAN Zhenguo(Department of General Surgery,Shanxi Bethunn Hospital,Shanxi Academy of Medical Sciences,Taiyuan 030032,China)
出处
《腹腔镜外科杂志》
2025年第5期341-348,共8页
Journal of Laparoscopic Surgery
