胃癌胃切除术和D2淋巴结切除术:谐波手术刀与常规手术刀的meta分析比较。

IF 1.6 Q4 ONCOLOGY International Journal of Surgical Oncology Pub Date : 2015-01-01 Epub Date: 2015-05-14 DOI:10.1155/2015/397260
Hang Cheng, Chia-Wen Hsiao, Jeffrey W Clymer, Michael L Schwiers, Bryanna N Tibensky, Leena Patel, Nicole C Ferko, Edward Chekan
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引用次数: 27

摘要

超声调和手术刀在解剖和凝血方面已经证明了临床和外科的好处。为了评估其在胃切除术中的应用,我们对随机对照试验进行了系统回顾和荟萃分析,比较了调和手术刀与常规手术刀在胃癌患者胃切除术中的应用。在没有语言限制的情况下检索国际数据库,比较开放或腹腔镜胃切除术和淋巴结切除术。荟萃分析对所有结果采用随机效应模型;连续变量分析平均差异,二分类变量分析风险比。对研究质量、常规技术类型和研究结果的归因进行敏感性分析。10项研究(N = 935)符合纳入标准。与传统止血技术相比,谐波手术刀显著缩短了手术时间(-27.5 min;P < 0.001),术中出血量(-93.2 mL;P < 0.001),引流量(-138.8 mL;P < 0.001)。在住院时间、并发症风险和输血方面,传统技术的结果在数字上更高,但没有达到统计学意义。结果在敏感性分析中仍然是稳健的。这项荟萃分析表明,与传统技术相比,使用谐波手术刀具有明显的优势,在接受胃切除术和淋巴结切除术的患者的几个结果测量中都有改善。
本文章由计算机程序翻译,如有差异,请以英文原文为准。

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Gastrectomy and D2 Lymphadenectomy for Gastric Cancer: A Meta-Analysis Comparing the Harmonic Scalpel to Conventional Techniques.

The ultrasonic Harmonic scalpel has demonstrated clinical and surgical benefits in dissection and coagulation. To evaluate its use in gastrectomy, we conducted a systematic review and meta-analysis of randomized controlled trials comparing the Harmonic scalpel to conventional techniques in gastrectomy for patients with gastric cancer. International databases were searched without language restrictions for comparisons in open or laparoscopic gastrectomy and lymphadenectomy. The meta-analysis used a random-effects model for all outcomes; continuous variables were analyzed for mean differences and dichotomous variables were analyzed for risk ratios. Sensitivity analyses were conducted for study quality, type of conventional technique, and imputation of study results. Ten studies (N = 935) met the inclusion criteria. Compared with conventional hemostatic techniques, the Harmonic scalpel demonstrated significant reductions in operating time (-27.5 min; P < 0.001), intraoperative blood loss (-93.2 mL; P < 0.001), and drainage volume (-138.8 mL; P < 0.001). Results were numerically higher for conventional techniques for hospital length of stay, complication risk, and transfusions but did not reach statistical significance. Results remained robust to sensitivity analyses. This meta-analysis demonstrates the clear advantages of using the Harmonic scalpel compared to conventional techniques, with improvements demonstrated across several outcome measures for patients undergoing gastrectomy and lymphadenectomy.

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来源期刊
CiteScore
3.70
自引率
0.00%
发文量
5
审稿时长
20 weeks
期刊介绍: International Journal of Surgical Oncology is a peer-reviewed, Open Access journal that publishes original research articles, review articles, and clinical studies in all areas of surgical oncology.
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