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目的:评价3D腹腔镜技术在胃癌手术中的应用效果及安全性。方法:检索多个国内外文献数据库,收集3D腹腔镜应用于胃癌手术的临床对照研究。由2名独立研究者根据纳入与排除标准对文献进行筛选、提取资料和评价质量后,采用RevMan 5.2软件进行Meta分析。结果:最终纳入7项研究,共有650例患者。Meta分析结果显示,与对照组(2D腹腔镜手术)比较,3D腹腔镜手术的手术持续时间缩短(MD=-0.59,95%CI=-0.76~-0.42,P<0.000 01),术中出血量减少(MD=-0.56,95%CI=-0.73~-0.39,P<0.000 01),住院费用增加(MD=378.42,95%CI=171.81~585.04,P=0.000 3)。所纳入的研究显示,3D腹腔镜手术在其他疗效指标及安全性方面与对照组无统计学差异(均P>0.05)。结论:3D腹腔镜辅助胃癌手术在手术时间与术中出血量方面具有优势,手术安全性较好,但手术费用偏高。
Objective: To evaluate the effect and safety of 3D laparoscopy in gastric cancer surgery. Methods: A number of domestic and foreign literature databases were searched and collected for clinical control study of 3D laparoscopy applied to gastric cancer surgery. Two independent investigators screened the literature based on inclusion and exclusion criteria, extracted data, and evaluated the quality of the data. Meta-analysis was performed using RevMan 5.2 software. Results: Finally, seven studies were included, with a total of 650 patients. Meta-analysis showed that the operative duration of 3D laparoscopic surgery was shorter (MD = -0.59, 95% CI = -0.76 -0.42, P <0.000 01) compared with that of the control group (2D laparoscopic surgery) (MD = -0.56, 95% CI = -0.73 -0.39, P <0.000 01), hospitalization costs increased (MD = 378.42,95% CI = 171.81 ~ 585.04, P = 0.0003). Included in the study, 3D laparoscopic surgery in other efficacy indicators and safety and the control group was no significant difference (all P> 0.05). Conclusion: 3D laparoscopic assisted gastric cancer surgery has advantages in operation time and intraoperative blood loss, and the operation safety is good, but the operation cost is high.