摘要
摘要目的通过Meta分析的方法对经左右胸手术路径治疗胸中段食管癌的疗效进行对比,为临床胸中段食管癌手术路径的选择提供证据.方法检索中国知识资源总库、万方数据库、维普数据库、pubmed、Medline等数据库,检索时间为建库至２０１４年６月.收集经左右胸治疗胸中段食管癌疗效对比的相关文献,并按纳入与排除标准筛选文献,同时对纳入的文献进行质量评价.数据分析采用RevMan５．２软件进行分析.检验异质性,选择相应效应模型合并统计量,通过漏斗图等评定有无发表偏倚.结果共纳入９篇文献,病例数合计１５１４例,其中右胸组６４８例,左胸组８６６例.分析结果显示右胸组在手术时间(WMD＝７８．１１,９５％CI６０．９９,９５．２２,P＜０．００００１)、术中出血量(WMD＝６４．９１,９５％CI４７．４０,８２．４２,P＜０．００００１)、淋巴结清扫数目(WMD＝４．９４,９５％CI３．５８,６．２９,P＜０．００００１)比左胸组多,术后３年生存率(OR＝１．６８,９５％CI１．３２,２．１２,P＜０．０００１)、并发症发生率(OR＝２．０６,９５％CI１．６４,２．５９,P＜０．００００１)比左胸组高;右胸组在术后３年复发率(OR＝０．６６,９５％CI０．５１,０．８４,P＝０．００１)比左胸组低.结论经右胸手术路径治疗中段食管癌虽然在手术时间、术中出血量及术后并发症发生率方面较经左胸路径处于劣势,但在清扫淋巴结数目、术后３年复发率及术后３年生存率方面更具优势,因此经右胸路径治疗中段食管癌值得推广.关键词胸中段食管癌;右胸;左胸;meta分析TherightandleftchestsurgerypathtreatmentthemiddleesophagealcancerofmetaanalysisZHENGWei,SHENXueyuan．(DepartmentofThoracicsurgery,theYongchuanaffiliatedhospitalofChongqingmedicaluniversity,Chongqing,Yongchuan,４０２１６０,P．R．China)AbstractObjectiveEvaluationbyusingthemethodofmetaanalysisontherightpathofthoracicsurgeryortheleftbreastsurgerytreatmentinperiodofthecurativeeffectofesophagealcancer,provideevidencetoawiderangeofclinicalapplication．MethodsRetrievetheknowledgeresourcepool,adatabaseoftenthousand,CNKI,pubmedandMedlinedatabase,VIPdatabaseretrievaltimeforlibraryuntilJune２０１４．Collectedbytherightchestandleftchestsurgerypathinperiodofesophagealcancercurativeeffectcomparisonofrelatedliterature,andaccordingtotheselectedinclusioncriteriaandexclusioncriteriaselectionliteraＧture,atthesametimeintothequalityofliteratureevaluation．DataanalysisUSEStheRevMan５．２softwareforanalysis．Inspectionheterogeneity,choosethecorＧrespondingeffectmodelcombinedstatistics,figuretoevaluatethepresenceofpublicationbias,suchasthroughafunnel．ResultsIntoninearticles,thenumberofcasestotal１５１４cases,amongthemtherightchestgroup６４８cases,groupof８６６casesoftheleftbreast．Analysisresultsshowthattherightchestinoperatingtime(WMD＝７８．１１,９５％CI７８．１１,６０．９９,P＜０．００００１),intraoperativebloodloss(WMD＝６４．９１,９５％CI６４．９１,４７．４０,P＜０．００００１),numberoflymphnodecleaning(WMD＝４．９４,９５％CI４．９４,３．５８,P＜０．００００１)thantheleftchestgroup,after３yearsofsurvivalrate(OR＝１．６８,９５％CI１．６８,１．６８,P＜０．０００１),theincidenceofcomplications(OR＝２．０６,９５％CI２．０６,２．０６,P＜０．００００１)higherthantheleftchestgroup;Rightchestgroup３yearsreＧcurrenceaftersurgery(OR＝０．６６,９５％CI０．６６,０．６６,P＝０．００１)islowerthantheleftchestgroup．ConclusionAlthoughthemiddlepathrightchestsurgerytreatmentofesophagealinoperationtime,intraoperativebloodlossandpostoperativecomplicationsisthepathtotheleftbreastatadisadvantage,butincleaningthelymphnodenumber,postoperativerecurrencerateandpostoperativesurvivalratein３years３yearsmoreadvantages,sotherightpathtreatmentofmiddlethoraciKceeysowporhdasgealcancerisworthpromoting．Middleesophagealcancer;Rightchest;Leftchest;Meta－analysis中图分类号文献标识码B文章编号１００１－５３０２(２０１５)０９－０７５２－０２
出版日期
2015年09月19日（中国期刊网平台首次上网日期，不代表论文的发表时间）
