期刊文献+

直肠癌侧方淋巴结清扫术安全性与有效性的系统评价 被引量:10

Systematic review on safety and efficacy of lateral node dissection in rectal cancer
原文传递
导出
摘要 目的评价直肠癌根治术行侧方淋巴结清扫的安全性和有效性。方法共检索出符合人选标准的对照临床研究27项,用固定效应模型和随机效应模型对直肠癌侧方淋巴结清扫组与非清扫组的安全性和有效性指标进行Meta分析。结果与非侧方淋巴结清扫组相比,侧方淋巴结清扫的手术时间延长(P=0.0005),术中出血量增加(P=0.0003),小便功能障碍发生率增加(P=0.001),术后总并发症、盆腔脓肿、吻合口瘘发生率、排便功能和性功能障碍、术后总复发率、局部复发、远处转移、5年生存率差异无统计学意义。结论直肠癌根治术行侧方淋巴结清扫在预防肿瘤复发、远处转移及提高术后生存率等有效性方面未见明显优势,却延长了手术时间,增加术中出血和小便功能障碍等并发症发生率。 Objective To evaluate the safety and efficacy of lateral node dissection in rectal cancer. Methods Data of safety and efficacy in 27 case-controlled studies comparing lateral node dissection and non-lateral node dissecion in rectal cancer were meta-analyzed using fixed effect model or random effect model. Results The increased operating time, blood loss and urinary dysfunction were more common in lateral node dissection group. The postoperative total complications, pelvic abscess, anastomotic leak, sexual dysfunction and defecation dysfunction were similar in both groups. There was no reasonably clear evidence in favor of lateral node dissection for recurrance, local recurrance, distal metastasis and 5-year survival. Conclusion Lateral node dissection can neither reduce recurrence nor improve survival in the current study, which is not recommended to be a routine procedure in rectal caner surgery.
出处 《中华胃肠外科杂志》 CAS 北大核心 2009年第3期229-235,共7页 Chinese Journal of Gastrointestinal Surgery
基金 广东省科技计划项目(2008B030301319)
关键词 直肠肿瘤 侧方淋巴结清扫 系统评价 Rectal neoplasms Lateral node dissection Systematic review
  • 相关文献

参考文献32

  • 1Japanese Society for Cancer of the Colon and Rectum. General Rules for Clinical and Pathological Studies on Cancer of the Colon, Rectum and Anus. 7^th edition. Tokyo : Kanehara, 2006.
  • 2Sobin LH, Wittekind C. International Union Against Cancer: TNM Classification of Malignant Tumours. 6^th edition. New York : Wiley-Liss, 2002.
  • 3Tjandra JJ, Kilkenny JW, Buie WD, et al. Practice parameters for the management of rectal cancer (revised). Dis Colon Rectum, 2005,48(3) :411-423.
  • 4Enker WE, Pilipshen SJ, Heilweil ML, et al. En bloc pelvic lymphadenectomy and sphincter preservation in the surgical management of rectal cancer. Ann Surg, 1986,203(4) :426-433.
  • 5Michelassi F, Block GE, Vannucci L, et al. A 5- to 21-year follow-up and analysis of 250 patients with rectal adenocarcinoma. Ann Surg, 1988,208 (3) : 379-389.
  • 6Hojo K, Sawada T, Moriya Y. An analysis of survival and voiding, sexual function after wide iliopelvic lymphadenectomy in patients with carcinoma of the rectum, compared with conventional lymphadeneetomy. Dis Colon Rectum, 1989,32(2) : 128-133.
  • 7Michelassi F, Block GE. Morbidity and mortality of wide pelvic lymphadenectomy for rectal adenocarcinoma. Dis Colon Rectum, 1992,35 (12) : 1143-1147.
  • 8Moreira LF, Hizuta A, Iwagaki H, et al. Lateral lymph node dissection for rectal carcinoma below the peritoneal reflection. Br J Surg, 1994,81(2) :293-296.
  • 9Suzuki K, Muto T, Sawada T. Prevention of local recurrence by extended lymphadenectomy for rectal cancer. Surg Today, 1995,25 (9) :795-801.
  • 10Havenga K, Enker WE, Norstein J, et al. Improved survival and local control after total mesorectal excision or D3 lymphadenectomy in the treatment of primary rectal cancer: an international analysis of 1411 patients. Eur J Surg Oncol, 1999,25 (4) : 368-374.

二级参考文献46

共引文献118

同被引文献179

引证文献10

二级引证文献106

相关作者

内容加载中请稍等...

相关机构

内容加载中请稍等...

相关主题

内容加载中请稍等...

浏览历史

内容加载中请稍等...
;
使用帮助 返回顶部