目的：评价有既往腹部手术史患者行腹腔镜胃癌根治手术的安全性、有效性。方法：检索中、外文献数据库自建库以来收录的关于有既往腹部手术史与无既往腹部手术史患者行腹腔镜胃癌根治手术的对比文献，按照纳入及排除标准筛选文献、提取数据、质量评价后，用RevMan 5.3软件行Meta分析。结果：最终纳入5篇文献共计6个研究，982例患者，其中有既往腹部手术史286例，既往无腹部手术史696例。Meta分析结果显示，与无既往腹部手术史患者比较，既往有无腹部手术史患者行腹腔镜胃癌根治手术的手术时间延长（WMD=15.51，95% CI=12.74~18.28，P<0.05），但术中出血量（WMD=-0.36，95% CI=-9.65~8.92）、术中淋巴结清扫情况（WMD=1.78，95% CI=-2.36~5.92）、住院时间（WMD=0.65，95% CI=-0.33~1.62）、术后并发症发生率（OR=1.63，95% CI=0.97~2.75）等均无统计学差异（均P>0.05）。结论：既往腹部手术史对行腹腔镜胃癌根治术无明显影响，该手术安全、可行。
Influence of history of prior abdominal surgery on performing laparoscopic-assisted radical gastrectomy: a Meta-analysis
Objective: To assess the safety and efficacy of performing laparoscopic-assisted radical gastrectomy in patients with a history of prior abdominal surgery. Methods: The literature of studies comparing laparoscopy-assisted gastrectomy for patients with and without previous abdominal surgery was searched in several databases since their inception. After literature screening based on the inclusion criteria and exclusion criteria, data extraction and quality assessment, Meta-analysis was performed by Revman 5.3 software. Results: Five articles with 6 studies were finally included, involving a total of 982 patients, of whom 286 cases had a history of abdominal surgery and 696 cases did not. Results of this Meta-analysis indicated that in patients with previous history of abdominal surgery compared with those without history of abdominal surgery, the operative time was prolonged (WMD=15.51, 95% CI=12.74–18.28, P<0.05), but all other variables that included intraoperative blood loss (WMD=–0.36, 95% CI=–9.65–8.92), status of intraoperative lymph node dissection (WMD=1.78, 95% CI=–2.36–5.92), length of hospitalization (WMD=0.65, 95% CI=–0.33–1.62), and incidence of postoperative complications (OR=1.63, 95% CI=0.97–2.75) had no statistical difference (all P>0.05). Conclusion: History of abdominal surgery exerts no significant influence on performing laparoscopic-assisted gastrectomy, so this procedure is safe and feasible.