本文選題：肺腫瘤 + 完全電視胸腔鏡手術(shù)��； 參考：《中國(guó)肺癌雜志》2017年05期

【摘要】：背景與目的目前未見(jiàn)對(duì)全電視胸腔鏡手術(shù)與胸腔鏡輔助小切口手術(shù)治療非小細(xì)胞肺癌臨床療效和安全性的系統(tǒng)評(píng)價(jià)。在本meta分析中,我們比較兩組手術(shù)治療非小細(xì)胞肺癌的臨床效果。方法系統(tǒng)地檢索7個(gè)主要的醫(yī)學(xué)期刊數(shù)據(jù)庫(kù):PubMed、Embase、CNKI、VIP、ISI Web of Science、the Cochrane Library和CBM,收集時(shí)間涵蓋2006年5月-2016年5月的有關(guān)完全電視胸腔鏡手術(shù)與胸腔鏡輔助小切口手術(shù)治療非小細(xì)胞肺癌的隨機(jī)對(duì)照研究(randomized controlled trials,RCT)。由兩名研究者對(duì)文獻(xiàn)質(zhì)量獨(dú)立進(jìn)行評(píng)價(jià)并提取相關(guān)數(shù)據(jù),采用Rev Man 5.3軟件進(jìn)行meta分析。結(jié)果共納入13篇RCT,共1,605例患者。其中完全電視胸腔鏡組(video-assisted thoracoscopic surgery,VATS)815例,胸腔鏡輔助小切口組(video-assisted mini-thoracotomy,VAMT)790例。Meta分析結(jié)果顯示:全胸腔鏡手術(shù)與胸腔鏡輔助小切口手術(shù)治療非小細(xì)胞肺癌相比,手術(shù)時(shí)間(SMD=13.56,95%CI:4.96-22.16)、術(shù)中出血量(SMD=-33.68,95%CI:-45.70--21.66)、胸腔引流管留置時(shí)間(SMD=-1.05,95%CI:-1.48--0.62)、胸腔引流量(SMD=-83.69,95%CI:-143.33--24.05)、術(shù)后疼痛程度(SMD=-1.68,95%CI:-1.98--1.38)、術(shù)后住院時(shí)間(SMD=-2.27,95%CI:-3.23--1.31)、兩組淋巴結(jié)清掃數(shù)目(SMD=-0.48,95%CI:-0.80--0.17)等方面的差異有統(tǒng)計(jì)學(xué)意義;而兩組術(shù)中的并發(fā)癥發(fā)生率(SMD=0.83,95%CI:0.54-1.29)、手術(shù)死亡率(SMD=0.95,95%CI:0.55-1.63)和1年復(fù)發(fā)率(RR=0.87,95%CI:0.34-2.24)差異無(wú)統(tǒng)計(jì)學(xué)意義(P0.05)。結(jié)論完全電視胸腔鏡手術(shù)與胸腔鏡輔助小切口切除術(shù)相比,治療非小細(xì)胞肺癌的并發(fā)癥發(fā)生率和手術(shù)死亡率相當(dāng),但二者在淋巴結(jié)清掃數(shù)目、手術(shù)時(shí)間、術(shù)中出血量、胸腔引流量、胸腔引流管留置時(shí)間、術(shù)后疼痛程度和術(shù)后住院時(shí)間等方面有差異�，F(xiàn)有的臨床資料顯示:相比胸腔鏡輔助小切口手術(shù),全胸腔鏡手術(shù)是治療早期非小細(xì)胞肺癌更好的選擇。
[Abstract]:Background and objective there is no systematic evaluation of the clinical efficacy and safety of total video-assisted thoracoscopic surgery and thoracoscopic assisted small-incision surgery in the treatment of non-small cell lung cancer (NSCLC). In this meta analysis, we compared the clinical outcomes of the two groups in the treatment of non-small cell lung cancer. Methods A systematic search of 7 major medical journal databases, called: PubMedbase, CNKIK, VIPISI Web of Science of the Cochrane Library and CBMs, was carried out for the period from May 2006 to May 2016 for the treatment of non-small cells with complete video-assisted thoracoscopic surgery and thoracoscopic assisted mini-incision surgery, covering the period from May 2006 to May 2016. Lung cancer: a randomized controlled study of (randomized controlled trialsm. The literature quality was evaluated independently by two researchers and the relevant data were extracted. The meta analysis was carried out by using Revman 5.3 software. Results A total of 13 RCTs were included, with a total of 1605 patients. There were 815 cases in video-assisted thoracoscopic vats group and 790 cases in video-assisted mini-thoracoscopic group. Meta-analysis showed that total thoracoscopic surgery was compared with thoracoscopic assisted small-incision surgery in the treatment of non-small cell lung cancer. 鎵嬫湳鏃墮棿(SMD=13.56,95%CI:4.96-22.16),鏈腑鍑?guó)櫋�閲，

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