【摘要】 目的对经腹膜与腹膜后腹腔镜下肾部分切除术的疗效和安全性进行比较。方法检索Pub Med、Medline、CNKI、万方及维普中关于经腹膜与腹膜后腹腔镜下肾部分切除术疗效和安全性对比的文献,通过Rev Man 12.0以SMD或RR及其95%CI对各项指标进行合并。结果共纳入10篇文献,分析显示经腹膜入路手术时间[SMD(95%CI):0.73(0.57,0.88)]、出血量[SMD(95%CI):0.34(0.02,0.65)]及住院时间[SMD(95%CI):0.56(0.36,0.76)]均明显大于腹膜后腹腔镜下肾部分切除术,而肾热缺血时间[SMD(95%CI):0.52(-0.19,1.23)]及总体并发症发生率[RR(95%CI):1.10(0.82,1.48)]无明显差异。结论对于适合肾部分切除术的患者,与经腹膜入路相比,腹膜后腹腔镜下肾部分切除术能明显缩短手术时间和住院时间,并能减少出血量。更多还原

【Abstract】 Objective To compare the efficacy and safety of retroperitoneal laparoscopic and retroperitoneal laparoscopic partial nephrectomy. Methods We conducted a systematic literature search with Pub Med, Medline, CNKI, Wang Fang and VIP to identify the relevant studies which reported the comparison of retroperitoneal laparoscopic and retroperitoneal laparoscopic partial nephrectomy. SMD or RR and its corresponding 95% CI were used to estimate the outcomes of interest by Rev Man 12.0. Results Ten retrospective studies were identified. Compared with retroperitoneal laparoscopic, transperitoneal laparoscopic partial nephrectomy had a longer operating time, SMD(95% CI) was 0.73(0.57, 0.88), a higher estimated blood loss, SMD(95% CI) was 0.34(0.02, 0.65), and a longer length of hospital stay, SMD(95% CI) was 0.56(0.36, 0.76), however, there were no differences between transperitoneal laparoscopic and retroperitoneal laparoscopic partial nephrectomy in warm ischaemia time, SMD(95% CI) was 0.52(-0.19, 1.23), and overall complication rate, RR(95% CI) was 1.10(0.82, 1.48). Conclusions Compared with transperitoneal laparoscopic, in appropriately selected patients, retroperitoneal laparoscopic partial nephrectomy has a shorter operating time and length of hospital stay, and reduce the estimated blood loss, retroperitoneal laparoscopic partial nephrectomy may be more efficient and safer.更多还原