摘要
目的:探讨精准肝切除治疗原发性肝癌的安全性和有效性。方法:选择中国知网、万方数据库、维普网、PubMed、Cochrane Library、Web of Science数据库检索关于精准肝切除与常规肝切除治疗原发性肝癌的文献,用RevMan5.3版软件进行荟萃分析。结果:共有33篇文献被纳入研究,共3987例患者,其中精准组2102例,常规组1885例。荟萃分析结果显示:与常规组相比较,精准组手术时间延长(MD=31.77,P<0.00001),而在术中出血量(MD=−173.50,P<0.00001),住院时间(MD=−4.55,P<0.00001),术后肝功能指标谷草转氨酶AST(MD=−27.76,P<0.00001)、谷丙转氨酶ALT(MD=−56.99,P<0.00001)、总胆红素TBiL(MD=−4.79,P<0.00001)、血清白蛋白ALB(MD=6.63,P<0.00001)、术后总并发症发生率(OR=0.34,P<0.00001)、标本切缘阳性率(OR=0.31,P<0.00001)、复发转移率(OR=0.62,P<0.0001)及术后1年生存率(OR=1.80,P<0.00001)方面均有优势。结论:应用精准外科理念的肝切除治疗原发性肝癌是一种安全、有效的方法,可以减少术中出血量,降低手术风险,降低术后并发症发生率,提高患者预后生活质量,具有更佳的近期疗效。
Objective:To explore the safety and effectiveness of precise hepatectomy in the treatment of primary liver cancer.Methods:The literatures about precise hepatectomy and conventional hepatectomy for primary liver cancer were retrieved from CNKI,WanFang Data Knowledge Service Platform,VIP,PubMed,Cochrane Library and Web of Science database.Results:A total of 33 articles were included in the study,including 3987 patients,2102 in the precision group and 1885 in the conventional group.Meta-analysis results showed that compared with the conventional group,the operation time of the precision group was prolonged(MD=31.77,P<0.00001),while the precision group did better than the conventional group in the intraoperative blood loss(MD=−173.50,P<0.00001),and the length of hospital stay(MD=−4.55,P<0.00001),postoperative liver function indicators of aspartate aminotransferase AST(MD=−27.76,P<0.00001),alanine aminotransferase ALT(MD=−56.99,P<0.00001),total bilirubin TBiL(MD=−4.79,P<0.00001),serum albumin ALB(MD=6.63,P<0.00001),total postoperative complication rate(OR=0.34,P<0.00001),positive margin of specimen resection(OR=0.31,P<0.00001),recurrence and metastasis rate(OR=0.62,P<0.0001)and Surgical 1-year survival rate(OR=1.80,P<0.00001).Conclusion:Hepatectomy based on the concept of precision surgery is a safe and effective method for the treatment of primary liver cancer.It can reduce the amount of intraoperative bleeding,the risk of surgery,and the incidence of postoperative complications,improve the quality of life of patients with prognosis,and have better short-term effects.
作者
郭昊苏
刘宏
李凯
杨易戎
GUO Haosu;LIU Hong;LI Kai;YANG Yirong(First Clinical Medical College,Shanxi Medical University,Taiyuan 030000;Department of Hepatobiliary Surgery,First Hospital of Shanxi Medical University,Taiyuan 030000,China)
出处
《临床与病理杂志》
CAS
2021年第2期395-409,共15页
Journal of Clinical and Pathological Research
关键词
精准肝切除
原发性肝癌
常规肝切除
精准外科理念
荟萃分析
precise hepatectomy
primary liver cancer
conventional hepatectomy
precise surgical concept
Meta-analysis
