The Comparison of Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction versus Mini-Laparotomy Specimen Extraction for Colorectal Tumours: A Systematic Review and Meta-Analysis of Short-Term Outcomes
The Comparison of Laparoscopic Colorectal Resection with Natural Orifice Specimen Extraction versus Mini-Laparotomy Specimen Extraction for Colorectal Tumours: A Systematic Review and Meta-Analysis of Short-Term Outcomes
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DOI：
10.1155/2020/8024789
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发表时间：
2020-01-31
影响因子：
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通讯作者：
Shen, Zhong
中科院分区：
文献类型：
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作者：
He, Jun;Hu, Jun-Feng;Shen, Zhong
瞄准！本研究的目的是比较自然腔道标本提取手术（NOSES）和传统腹腔镜手术（CLAPS）治疗结直肠肿瘤的短期结局，并评价NOSES在结直肠切除术中的安全性和可行性。方法.对截至2019年3月的PubMed、科克伦图书馆和Embase数据库进行了文献综述。符合纳入标准的论文用于进一步分析。短期结果包括术中结果和术后恢复结果。计算连续结果的加权平均差（WMD）和二分结果的比值比（OR）。使用Newcastle-Ottawa质量评估量表（NOS）或6项Jadad量表评价研究质量。结果8项研究（包括686例患者）符合纳入标准。与CLAPS相比，NOSES在术后并发症、术后疼痛、胃肠功能恢复、住院时间和美容效果方面更具优势。NOSES中采集的淋巴结和术中失血量与CLAPS相当;然而，NOSES中观察到手术时间延长。结论.就短期结果而言，NOSES被证明是结直肠肿瘤学中CLAPS的安全可行的替代方案。需要进一步的长期和随机试验。
Aim. The aims of this study were to compare the short-term outcomes of natural orifice specimen extraction surgery (NOSES) and conventional laparoscopic surgery (CLAPS) for colorectal tumours and to evaluate the safety and feasibility of NOSES in colorectal resection. Methods. A literature review was performed on the PubMed, Cochrane Library, and Embase databases up to March 2019. Papers conforming to the inclusion criteria were used for further analysis. The short-term outcomes included intraoperative outcomes and postoperative recovery results. The weighted mean difference (WMD) was calculated for continuous outcomes and odds ratio (OR) for dichotomous results. Study quality was evaluated using the Newcastle-Ottawa Quality Assessment Scale (NOS) or the 6-item Jadad scale. Results. Eight studies comprising 686 patients met the inclusion criteria. Compared with CLAPS, NOSES had more advantages in terms of postoperative complications, postoperative pain, recovery of gastrointestinal function, duration of hospital stay, and cosmetic results. The lymph nodes harvested and intraoperative blood loss in NOSES were comparable with CLAPS; however, a prolonged operative time was observed in NOSES. Conclusions. NOSES was shown to be a safe and viable alternative to CLAPS in colorectal oncology in terms of short-term results. Further long-term and randomized trials are required.