【摘要】 目的系统评价3D腹腔镜治疗结直肠癌的临床效果和安全性。方法计算机检索PubMed、EMbase、The Cochrane Library、CBM、VIP、WanFang Data和CNKI数据库,搜集有关3D腹腔镜辅助结直肠癌手术治疗的临床研究,检索时限均为建库至2018年9月1日。由2名研究者独立筛选文献、提取资料并评价纳入研究的偏倚风险后,采用RevMan 5.3软件进行Meta分析。结果共纳入26个临床研究,包括4个随机对照试验和22个队列研究。Meta分析结果显示:与2D腹腔镜相比,3D腹腔镜辅助结直肠癌手术治疗的手术时间更短[MD=–16.32,95%CI(–22.61,–10.03),P<0.000 01]、术中出血量更少[MD=–10.80,95%CI(–19.93,–1.66),P=0.02]、清扫淋巴结数目更多[MD=0.88,95%CI(0.30,1.45),P=0.003]、胃肠道功能恢复时间更短[MD=–0.18,95%CI(–0.31,–0.04),P=0.01]、术后并发症发生率更低[OR=0.63,95%CI(0.44,0.89),P=0.009]、住院天数更短[MD=–0.84,95%CI(–1.40,–0.28),P=0.003],两组差异均有统计学意义。两组住院费用[MD=–0.01,95%CI(–0.23,0.21),P=0.94]的差异无统计学意义。结论当前证据表明,与传统2D腹腔镜辅助结直肠癌手术相比,3D腹腔镜辅助结直肠癌手术具有术中出血少、手术时间短、术后并发症发生率低、住院时间短、不增加住院费用等优势。受纳入研究数量和质量的限制,上述结论尚待更多高质量研究予以验证。更多还原

【Abstract】 Objectives To systematically review the efficacy and safety of 3 D laparoscopic in the treatment of colorectal cancer. Methods PubMed, EMbase, The Cochrane Library, CBM, VIP, WanFang Data and CNKI databases were electronically searched online to collect clinical trials of 3 D laparoscopic in the treatment of colorectal cancer from inception to September 1 st, 2018. Two reviewers independently screened literature, extracted data and assessed the risk of bias of included studies. Meta-analysis was then performed using RevMan 5.3 software. Results A total of 26 trials,including 4 randomized controlled trials and 22 cohort studies were included. The results of meta-analysis showed that:compared with 2 D laparoscopic, 3 D laparoscopic had shorter operative time(MD=–16.32, 95%CI –22.61 to –10.03,P<0.000 01), less amount of blood transfusion in operation(MD=–10.80, 95%CI –19.93 to –1.66, P=0.02), more lymph node dissection(MD=0.88, 95%CI 0.30 to 1.45, P=0.003), shorter recovery time of gastrointestinal function(MD=–0.18,95%CI –0.31 to –0.04, P=0.01), lower incidence of postoperative complication(OR=0.63, 95%CI 0.44 to 0.89, P=0.009),and fewer days in hospital(MD=–0.84, 95%CI –1.40 to –0.28, P=0.003). Additionally, there was no significant difference in hospitalization costs(MD=–0.01, 95%CI –0.23 to 0.21, P=0.94). Conclusions Current evidence shows that, compared with 2 D laparoscopy, 3 D laparoscopy assisted colorectal cancer surgery has obvious advantages such as less bleeding during operation, shorter operation time, lower incidence of complications after operation, shorter hospitalization time and no increase in hospitalization expenses. Due to limited quality and quantity of the included studies, more high quality studies are required to verify above conclusions.更多还原