乳腺肿瘤专题研究(Monographic Study of Breast Tumors)

超声刀与电刀在乳腺癌手术中应用效果比较的Meta 分析

Published at: 2015年第24卷第11期

李孟天 1 , 刘刚 1 , 郁晓峰 1 , 孙旭凌 2 , 黄桂林 2
1 石河子大学医学院,新疆 石河子 832000
2 石河子大学医学院第一附属医院 普外二科,新疆 石河子 832000
通讯作者 桂林 黄 Email: 13899523416@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.11.009
基金:

摘要

目的:比较超声刀与传统电刀用于乳腺癌术中乳房组织切除、腋窝淋巴结清扫的疗效。方法:检索国内外数据库,收集相关随机对照试验(RCT),行文献筛选、质量评价和资料提取后,应用RevMan 5.2 软件完成Meta 分析。结果:共纳入8 个RCT,总样本量604 例,其中超声刀组300 例,电刀组304 例。Meta 分析结果显示,与电刀组比较,超声刀组手术时间无明显差异(WMD=6.20,95% CI=-5.02~17.41,P=0.28),但术中出血量(WMD=-61.42,95% CI=-83.76~-39.09)、术后引流量(WMD=-374.92,95% CI=-453.90~-295.95)、引流时间(WMD=-3.30,95% CI=-5.10~-1.49)、术后皮下积液发生率(RR=0.51,95% CI=0.38~0.68)均明显降低(均P<0.05)。结论:乳腺癌手术中,使用超声刀在控制术中出血量、减少术后引流、降低术后皮下积液方面优于电刀。


Ultrasonic scalpel versus electrocautery in breast cancer surgery: a Meta-analysis

Abstract

Objective: To compare the efficacy of ultrasonic scalpel and traditional electrocautery for mastectomy and axillary lymph node dissection in breast cancer surgery. Methods: The relevant randomized controlled trials (RTCs) were collected by searching the national and international databases. After literature screening, quality assessment and data extraction, Meta-analysis was performed by using RevMan 5.2 software. Results: Eight RTCs were finally included, with a total sample size of 604 cases comprising 300 cases in ultrasonic scalpel group and 304 cases in electrocautery group. Results of Meta-analysis showed that in ultrasonic scalpel group compared with electrocautery group, the operative time had no significant difference (WMD=6.20, 95% CI=-5.02–17.41, P=0.28), but the intraoperative blood loss (WMD=–61.42, 95% CI=–83.76––39.09), postoperative drainage volume (WMD=–374.92, 95% CI=–453.90––295.95), drainage time (WMD=–3.30, 95% CI=–5.10––1.49), and the incidence of subcutaneous fluid collection (RR=0.51, 95% CI=0.38–0.68) were all significantly decreased (all P<0.05). Conclusion: In breast cancer surgery, use of ultrasonic scalpel is superior to that of electrocautery in respects of intraoperative bleeding control, and reducing postoperative drainage and incidence of subcutaneous fluid collection.


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引用

引用本文: 孟天 李, 刚 刘, 晓峰 郁, 旭凌 孙, 桂林 黄. 超声刀与电刀在乳腺癌手术中应用效果比较的Meta 分析[J]. 中国普通外科杂志, 2015, 24(11): 1541-1546.
Cite this article as: LI Mengtian, LIU Gang, YU Xiaofeng, SUN Xuling, HUANG Guilin . Ultrasonic scalpel versus electrocautery in breast cancer surgery: a Meta-analysis[J]. Chin J Gen Surg, 2015, 24(11): 1541-1546.