临床研究(Clinical Research)

单孔腹腔镜技术在腹股沟疝修补术中临床应用价值的Meta分析

Published at: 2016年第25卷第10期

狐鸣 1 , 李军良 1 , 王婧 2 , 张永斌 1 , 马云涛 3
1 甘肃省人民医院肿瘤外科,甘肃 兰州 730000
2 兰州大学第二临床医学院,甘肃兰州730030
3 甘肃省人民医院中西结合急腹症中心,甘肃 兰州 730000
通讯作者 云涛 马 Email: doc_201605@hotmail.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2016.10.016
基金:
甘肃省兰州市城关区科技计划资助项目 2015-3-9

摘要

目的:探讨单孔腹腔镜技术应用于腹股沟疝修补术中的有效性和安全性。方法:计算机检索国内外文献数据库,收集比较单孔腹腔镜疝修补术与多孔腹腔镜疝修补术的临床研究,采用STATA 12.0进行Meta分析。结果:共纳入17项研究,其中随机对照试验5项,回顾性研究12项,涉及患者1722例。Meta分析结果显示,单孔腹腔镜疝修补术在术后恢复时间(SMD=-0.35,95% CI=-0.56~-0.15,P=0.001)及术后第7日疼痛评分(SMD=-0.27,95% CI=-0.53~-0.01,P=0.044)方面优于多孔腹腔镜疝修补术,而两者在手术时间(SMD=0.03,95% CI=-0.20~0.26,P=0.811)、术后住院时间(SMD=-0.07,95% CI=-0.23~0.09,P=0.393)、术后第1日疼痛评分(SMD=-0.19,95% CI=-0.45~0.07,P=0.153)、术后并发症发生率(OR=0.98,95% CI=0.69~1.38,P=0.896)、术后疝复发率(OR=1.07,95% CI=0.46~2.48,P=0.872)方面均无统计学差异。结论:与多孔腹腔镜疝修补术比较,单孔腹腔镜疝修补术能有效的减少患者术后恢复时间与术后疼痛,并能带来良好的美容效果,且具有相似的安全性和有效性。


Meta-analysis of application value of single-incision laparoscopic technique in inguinal hernia repair

Abstract

Objective: To evaluate the safety and efficacy of using single incision laparoscopic technique in inguinal hernia repair. Methods: The clinical studies comparing single- and multi-incision inguinal hernia repair were collected by searching several national and international databases. Meta-analysis was performed by using STATA 12.0 software. Results: Seventeen studies were finally enrolled, including 5 randomized controlled trials and 12 retrospective studies, and involving 1 722 patients. The results of Meta-analyses showed that single-incision inguinal hernia repair was superior to multi-incision inguinal hernia repair in respects of postoperative recovery time (SMD=–0.35, 95% CI=–0.56––0.15, P=0.001) and pain score on postoperative day 7 (SMD=–0.27, 95% CI=–0.53––0.01, P=0.044), while there was no significant difference between the two procedures in terms of operative time (SMD=0.03, 95% CI=–0.20–0.26, P=0.811), length of postoperative hospital stay (SMD=–0.07, 95% CI=–0.23–0.09, P=0.393), pain score on first postoperative day (SMD=–0.19, 95% CI=–0.45–0.07, P=0.153), and incidence of postoperative complications (OR=0.98, 95% CI=0.69–1.38, P=0.896) and recurrence of hernia (OR=1.07, 95% CI=0.46–2.48, P=0.872). Conclusion: Compared with multi-incision inguinal hernia repair, single-incision inguinal hernia repair can effectively reduce postoperative recovery time and pain of the patients, and provide favorable cosmetic results, and has similar safety and efficacy.


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引用

引用本文: 鸣 狐, 军良 李, 婧 王, 永斌 张, 云涛 马. 单孔腹腔镜技术在腹股沟疝修补术中临床应用价值的Meta分析[J]. 中国普通外科杂志, 2016, 25(10): 1461-1469.
Cite this article as: HU Ming, LI Junliang, WANG Jing, ZHANG Yongbin, MA Yuntao . Meta-analysis of application value of single-incision laparoscopic technique in inguinal hernia repair [J]. Chin J Gen Surg, 2016, 25(10): 1461-1469.