本文選題：賁門癌 + 根治性全胃切除術(shù)　； 參考：《蘭州大學(xué)》2017年碩士論文

【摘要】：目的系統(tǒng)評價(jià)根治性全胃切除術(shù)及根治性近端胃切除術(shù)治療賁門癌的療效及并發(fā)癥。方法計(jì)算機(jī)檢索PubMed、Web of Science、The Cochrane Library、中國生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫、萬方數(shù)據(jù)庫和中國知網(wǎng)等數(shù)據(jù)庫,查找關(guān)于根治性全胃切除術(shù)及根治性近端胃切除術(shù)治療賁門癌的相關(guān)研究文獻(xiàn),檢索時(shí)限均從建庫至2016年10月18日。由2位評價(jià)員按納入與排除標(biāo)準(zhǔn)獨(dú)立篩選文獻(xiàn)、提取資料并評價(jià)質(zhì)量后,采用RevMan 5.3軟件進(jìn)行Meta分析。結(jié)果共納入8個(gè)研究,522例患者。Meta分析結(jié)果顯示:與根治性近端胃切除術(shù)相比,根治性全胃切除術(shù)治療賁門癌在5年生存率[OR=1.84,95%CI(1.16,2.92),P=0.01]、3年生存率[OR=1.95,95%CI(1.30,2.93),P=0.001]、吻合口瘺發(fā)生率[OR=0.39,95%CI(0.16,0.94),P=0.03]、反流發(fā)生率[OR=0.12,95%CI(0.04,0.36),P=0.0002]方面差異均有統(tǒng)計(jì)學(xué)意義。在1年生存率[OR=1.31,95%CI(0.66,2.60),P=0.44]、吻合口狹窄發(fā)生率[OR=0.53,95%CI(0.16,1.69),P=0.28]、腸梗阻發(fā)生率[OR=0.39,95%CI(0.14,1.09),P=0.07]、切口感染發(fā)生率[OR=0.79,95%CI(0.19,3.33),P=0.75]方面差異無統(tǒng)計(jì)學(xué)意義。結(jié)論現(xiàn)有證據(jù)表明,全胃切除術(shù)治療賁門癌效果良好且并發(fā)癥少。鑒于納入研量有限,上述結(jié)論尚需開展更多研究予以驗(yàn)證。
[Abstract]:Objective to evaluate the efficacy and complications of radical total gastrectomy and radical proximal gastrectomy in the treatment of cardiac carcinoma. Methods We searched the online database of PubMedus Web of Science of the Cochrane Library, the Chinese Biomedical Literature Database, the Wanfang Database and the Chinese knowledge Network, and searched for the relevant literatures on radical total gastrectomy and radical proximal gastrectomy in the treatment of cardiac carcinoma. The time limit for retrieval is from the construction of the database to October 18, 2016. According to the inclusion and exclusion criteria, two evaluators independently sifted the literature, extracted the data and evaluated the quality, and then analyzed the data by RevMan 5.3 software. Results A total of 522 patients were included in 8 studies. Meta-analysis showed that compared with radical proximal gastrectomy, The 5-year survival rate of radical total gastrectomy for cardiac cancer [OR1.8495 CIQ 1.162.92], the 3-year survival rate (OR1.9595CII 1.302.93P0.001), the incidence of anastomotic fistula (OR0.3995CI0.160.94P0.03), the incidence of reflux [OR0.1295CI0.040.36Pn002] were statistically significant. There was no significant difference in the incidence of anastomotic stenosis (OR0.53 / 95), intestinal obstruction (OR0.39 / 95CII 0.141.09P0.07), incisional infection (OR0.799CII 0.193.33P0.75) at 1 year survival rate [OR1. 31C 95 CIQ], anastomotic stoma stenosis rate (OR0. 5395 CII = 0. 669 P0. 28), and incisional infection rate (OR0.79 / 95CIT = 0. 193.33P0. 75), and there was no significant difference in the incidence of intestinal obstruction (OR 0.39 / 95 CII = 0.141.09 P0.07), and there was no significant difference in the incidence of incisional infection [OR0.79 / 95CIT 0.193.33P0.75] Conclusion the available evidence shows that total gastrectomy is effective in treating cardiac carcinoma with less complications. In view of the limited number of studies included, more studies are needed to verify the above conclusions.
【學(xué)位授予單位】：蘭州大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2

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