Clinical effect of laparoscopic hepatectomy in treating liver metastasis of colon cancer: a systematic review and meta-analysis
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摘要:
目的系统评价腹腔镜肝切除(LH)与传统开腹肝切除(OH)治疗结肠癌肝转移的临床效果。方法计算机检索Pub Med、Medline、Embase、Cochrane Library等数据库,截止时间至2014年10月,同时根据以上检索所得文献的参考文献进行扩大检索。对入选研究使用Jadad评分法进行质量评价,采用Cochrane协作网提供的Rev Man5.3.4统计软件进行Meta分析。结果共纳入10项符合标准的研究,共计786例患者。LH与OH相比,在手术时间、围手术期病死率、5年整体生存率方面差异均无统计学意义(95%CI分别为-61.9823.68、0.084.05、0.601.58,P值均>0.05)。而两组在术中出血量、术后并发症发生率以及住院时间方面差异均具有统计学意义(95%CI分别为-323.17-113.00、0.380.77、-5.01-2.04,P值均<0.05)。结论 LH应用于结肠癌肝转移的安全性及效果与OH一致,并具有...
Abstract:Objective To evaluate the clinical effects of laparoscopic hepatectomy (LH) versus open hepatectomy (OH) in treating liver metastasis of colon cancer. Methods Relevant literature published up to October 2014 was retrieved from databases including Pub Med, Medline, Embase, and Cochrane Library. Extended search was done with reference to the retrieved articles. The quality of selected studies was assessed by the Jadad scale. Meta-analysis was performed using the Cochrane Review Manager software (Version 5. 3. 4) . Results A total of 10 studies involving 786 patients met the inclusion criteria. Meta-analysis showed no significant differences in duration of operation, perioperative mortality, and 5-year overall survival rate between patients undergoing LH and OH (95% CI:-61. 98-23. 68, 0. 08-4. 05, and 0. 60-1. 58, respectively, P > 0. 05 for all) , but there were significant differences in intraoperative blood loss, incidence of postoperative complications, and length of hospital stay (95% CI:-323. 17- (-113. 00) , 0. 38-0. 77, and-5. 01- (-2. 04) , respectively, P < 0. 05) . Conclusion The results of this meta-analysis suggest that LH has comparable efficacy and safety to OH in treating liver metastasis of colon cancer and LH has its own advantage.
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Key words:
- laparoscopes /
- hepatectomy /
- colonic neoplasms /
- neoplasm metastasis /
- Meta-analysis
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[1]SUNG JJ, LAU JY, GOH KL, et al.Increasing incidence of colorectal cancer in Asia:implications for screening[J].Lancet Oncol, 2005, 6 (11) :871-876. [2]VAN CUTSEM E, NORDLINGER B, ADAM R, et al.Towards a pan-European consensus on the treatment of patients with colorectal liver metastases[J].Eur J Cancer, 2006, 42 (14) :2212-2221. [3]FONG Y, FORTNER J, SUN RL, et al.Clinical score for predicting recurrence after hepatic resection for metastatic colorectal cancer:analysis of 1001 consecutive cases[J].Ann Surg, 1999, 230 (3) :309-321. [4]CHOTI MA, SITZMANN JV, TIBURI MF, et al.Trends in long-term survival following liver resection for hepatic colorectal metastases[J].Ann Surg, 2002, 235 (6) :759-766. [5]PAWLIK TM, SCOGGINS CR, ZORZI D, et al.Effect of surgical margin status on survival and site of recurrence after hepatic resection for colorectal metastases[J].Ann Surg, 2005, 241 (5) :715-724. [6]TOMLINSON JS, JARNAGIN WR, DEMATTEO RP, et al.Actual 10-year survival after resection of colorectal liver metastases defines cure[J].J Clin Oncol, 2007, 25 (29) :4575-4780. [7]KANAS GP, TAYLOR A, PRIMROSE JN, et al.Survival after liver resection in metastatic colorectal cancer:review and meta-analysis of prognostic factors[J].Clin Epidemiol, 2012, 4:283-301. [8]MALA T, EDWIN B, GLADHAUG I, et al.A comparative study of the short-term outcome following open and laparoscopic liver resection of colorectal metastases[J].Surg Endosc, 2002, 16 (7) :1059-1063. [9]CASTAING D, VIBERT E, RICCA L, et al.Oncologic results of laparoscopic versus open hepatectomy for colorectal liver metastases in two specialized centers[J].Ann Surg, 2009, 250 (5) :849-855. [10]ABU H, UNDERWOOD T, ZUCCARO M, et al.Short-and medium-term results of totally laparoscopic resection for colorectal liver metastases[J].Br J Surg, 2010, 97 (6) :927-933. [11]CANNON RM, SCOGGINS CR, CALLENDER GG, et al.Laparoscopic versus open resection of hepatic colorectal metastases[J].Surgery, 2012, 152 (4) :567-574. [12]CHEUNG TT, POON RT, YUEN WK, et al.Outcome of laparoscopic versus open hepatectomy for colorectal liver metastases[J].ANZ J Surg, 2013, 83 (11) :847-852. [13]TOPAL H, TIEK J, AERTS R, et al.Outcome of laparoscopic major liver resection for colorectal metastases[J].Surg Endosc, 2012, 26 (9) :2451-2455. [14]QIU J, CHEN S, PANKAJ P, et al.Laparoscopic hepatectomy for hepatic colorectal metastases-a retrospective comparative cohort analysis and literature review[J].PLo S One, 2013, 8 (3) :e60153. [15]GUERRON AD, ALIYEV S, AGCAOGLU O, et al.Laparoscopic versus open resection of colorectal liver metastasis[J].Surg Endosc, 2013, 27 (4) :1138-1143. [16]INOUE Y, HAYASHI M, TANAKA R, et al.Short-term results of laparoscopic versus open liver resection for liver metastasis from colorectal cancer:a comparative study[J].Am Surg, 2013, 79 (5) :495-501. [17]IWAHASHI S, SHIMADA M, UTSUNOMIYA T, et al.Laparoscopic hepatic resection for metastatic liver tumor of colorectal cancer:comparative analysis of short-and long-term results[J].Surg Endosc, 2014, 28 (1) :80-84. [18]BUELL JF, KOFFRON AJ, THOMAS MJ, et al.Laparoscopic liver resection[J].J Am Coll Surg, 2005, 200 (3) :472-480. [19]UCHIYAMA K, UENO M, OZAWA S, et al.Combined use of contrast-enhanced intraoperative ultrasonography and a fluorescence navigation system for identifying hepatic metastases[J].World J Surg, 2010, 34 (12) :2953-2959.
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