【摘要】：目的該研究的目的是通過回顧現(xiàn)有文獻(xiàn),比較腹腔鏡腹膜外途徑和腹膜內(nèi)途徑行淋巴結(jié)切除術(shù)在婦科三大惡性腫瘤中的安全性及有效性。方法徹底而系統(tǒng)的檢索Pub Med、EMBASE、Cochrane、Scopus數(shù)據(jù)庫、中國知網(wǎng)(CNKI)、中國醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(CBM)及萬方醫(yī)學(xué)數(shù)據(jù)庫等數(shù)據(jù)庫,檢索時(shí)間限定為:建庫至2017年2月;手工檢索相關(guān)雜志和著作,搜集國內(nèi)外符合納入標(biāo)準(zhǔn)的非隨機(jī)對照試驗(yàn)。干預(yù)措施為:所有患者行腹腔鏡手術(shù),試驗(yàn)組采用腹膜外途徑淋巴結(jié)切除術(shù),對照組采用腹膜內(nèi)途徑淋巴結(jié)切除術(shù)。觀察指標(biāo)包括:手術(shù)時(shí)間、術(shù)中出血量、淋巴囊腫發(fā)生率、術(shù)中及術(shù)后并發(fā)癥發(fā)生率、淋巴結(jié)切除總數(shù)。采用Rev Man 5.3軟件對納入的研究進(jìn)行Meta分析。結(jié)果共納入7個(gè)符合要求的非隨機(jī)對照試驗(yàn),共計(jì)539例患者(其中腹膜外組271例,腹膜內(nèi)組268例)。與腹膜內(nèi)組相比,腹膜外組手術(shù)時(shí)間短,淋巴囊腫發(fā)生率、術(shù)中和術(shù)后并發(fā)癥發(fā)生率低;但在術(shù)中出血和淋巴結(jié)切除數(shù)目方面,兩組無明顯差異。結(jié)論在婦科三大惡性腫瘤腹腔鏡淋巴結(jié)切除手術(shù)中,腹膜外途徑較腹膜內(nèi)途徑在手術(shù)時(shí)間、淋巴囊腫發(fā)生率、術(shù)中和術(shù)后并發(fā)癥發(fā)生率等方面有明顯的優(yōu)勢,術(shù)中出血、腹主動脈旁淋巴結(jié)切除數(shù)目兩者相當(dāng)。
[Abstract]:Objective to compare the safety and efficacy of laparoscopic extraperitoneal and intraperitoneal lymphadenectomy in three gynecological malignancies. Methods complete and systematic retrieval of Pub Med,EMBASE,Cochrane,Scopus database, (CNKI), database of Chinese medical literature, (CBM) and Wanfang medical database, etc., were carried out thoroughly and systematically. The retrieval time was limited to the following: the database was built until February 2017, and the related magazines and works were searched manually. Collect non-randomized controlled trials that meet the inclusion criteria at home and abroad. The intervention measures were as follows: all patients underwent laparoscopic surgery, the experimental group received extraperitoneal lymphadenectomy and the control group underwent intraperitoneal lymphadenectomy. The parameters included: operative time, intraoperative bleeding, incidence of lymphocyst, intraoperative and postoperative complications, total lymph node resection. Rev Man 5.3 software was used to analyze the included research by Meta. Results A total of 539 patients (271 in extraperitoneal group and 268 in intraperitoneal group) were enrolled in 7 non-randomized controlled trials. Compared with the intraperitoneal group, the extraperitoneal group had shorter operation time, lower incidence of lymphocyst, and lower incidence of intraoperative and postoperative complications, but there was no significant difference in the number of intraoperative bleeding and lymph node resection between the two groups. Conclusion in laparoscopic lymphadenectomy for three major gynecological malignancies, the extraperitoneal approach is superior to the intraperitoneal approach in terms of the operative time, the incidence of lymphocysts, the incidence of complications during and after operation, and the intraoperative bleeding. The number of lymphadenectomies around the abdominal aorta was the same.
【學(xué)位授予單位】：廣西醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R737.3

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