文章摘要

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

作者: 1狐鸣, 1李军良, 2王婧, 1张永斌, 3马云涛
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: 马云涛 Email: doc_201605@hotmail.com
DOI: 10.3978/.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。
关键词： 疝，腹股沟 疝修补术 腹腔镜 Meta分析

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

Authors: 1HU Ming, 1LI Junliang, 2WANG Jing, 1ZHANG Yongbin, 3MA Yuntao
1 Department of Oncological Surgery, Gansu Provincial Hospital, Lanzhou 730000, China
2 The Second Clinical Medical College, Lanzhou University, Lanzhou 730030, China
3 Integrated Chinese and Western Medical Center for Acute Abdomen, Gansu Provincial Hospital, Lanzhou 730000, China

CorrespondingAuthor:MA Yuntao Email: doc_201605@hotmail.com

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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