肝切除在精准外科理念下治疗原发性肝癌近期疗效的荟萃分析
| 作者: |
1郭昊苏,
2刘宏,
1李凯,
1杨易戎
1 山西医科大学第一临床医学院，太原 030000 2 山西医科大学第一医院肝胆外科，太原 030000 |
| 通讯: |
刘宏
Email: 1367148364@qq.com |
| DOI: | 10.3978/j.issn.2095-6959.2021.02.023 |
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Meta分析。结果：共有33篇文献被纳入研究，共3 987例患者，其中精准组2 102例，常规组1 885例。Meta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。
关键词：
精准肝切除；原发性肝癌；常规肝切除；精准外科理念；Meta分析
Meta-analysis of the short-term efficacy of hepatectomy on primary liver cancer under the concept of precision surgery
CorrespondingAuthor: LIU Hong Email: 1367148364@qq.com
DOI: 10.3978/j.issn.2095-6959.2021.02.023
Abstract
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 3 987 patients, 2 102 in the precision group and 1 885 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 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.
Keywords：
precise hepatectomy; primary liver cancer; conventional hepatectomy; precise surgical concept; Meta-analysis