南方医科大学学报 ›› 2021, Vol. 41 ›› Issue (3): 464-470.doi: 10.12122/j.issn.1673-4254.2021.03.22

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腔镜手术与传统手术对腮腺良性肿瘤的治疗效果的meta分析

冯铁军,谢 宇,林雅琪,龚 薇,孟子璐,王玉栋   

  • 出版日期:2021-03-20 发布日期:2021-04-04

Comparison of endoscopic versus conventional surgery for benign parotid tumor: a meta analysis

  • Online:2021-03-20 Published:2021-04-04

摘要:

目的 通过比较腔镜手术与传统手术在治疗腮腺良性肿瘤效果的系统评价,比较两种手术方式的效果。方法 检索CNKI、PubMed、Web of Science、Embase、万方医学网等数据库在2021年1月以前发表的所有文章。对文章进行筛选及提取,使用Review Manager 5.3软件进行meta分析。结果 纳入8篇文章,4篇RCT研究,共532名患者,meta分析结果显示,在切口长度[加权平均差(WMD)=-5.73;95%CI:-6.84~-4.62]、术中预估出血量(WMD=-34.50;95%CI:-49.09~-19.91)、术后引流量(WMD=-21.72;95%CI:-29.31~-14.12)、切口满意度(WMD=2.23;95%CI:1.11~3.34)、短暂性面瘫(OR=0.37;95%CI:0.17~0.78)腔镜组优于传统组,在手术时间、涎瘘、Frey综合征以及肿瘤复发,两组手术差异无统计学意义。结论 腔镜下良性腮腺肿瘤切除在切口长度、术中预估出血量、术后引流量、切口满意度、短暂性面瘫方面优于传统组,但是在手术时间、唾液腺、Frey综合征以及肿瘤复发,两组手术差异不明显。因此腔镜下腮腺良性肿瘤切除优于传统手术,是一种安全的手术方式。

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Abstract:

To assess the efficacy and safety of endoscopic versus conventional surgery for benign parotid tumor. Methods We searched the electronic databases including PubMed, Embase, Web of Science, CNKI and Wanfang Data for studies published before January, 2021. A meta-analysis was performed using Rev Man 5.3 software. Results We retrieved 8 eligible studies involving a total of 532 patients, and 4 of the studies were RCT. The results of meta-analysis showed that endoscopic surgery was better than conventional surgery in terms of incision length (WMD=- 5.73; 95% CI: -6.84--4.62), intraoperative bleeding volume (WMD=-34.50; 95% CI: -49.09--19.91), postoperative drainage volume (WMD=- 21.72; 95% CI: - 29.31--14.12), subjective satisfaction with incision scar(WMD=2.23; 95%CI: 1.11-3.34), and temporary facial paresis (OR=0.37; 95%CI: 0.17-0.78). There were no significant differences in the operation time, salivary fistula, Frey's syndrome or tumor recurrence between the two groups. Conclusion For treatment of benign parotid tumor, endoscopic surgery is a safe surgical procedure and is superior to conventional surgery in terms of incision length, operative bleeding volume, postoperative drainage volume, subjective satisfaction with incision scar, and temporary facial paresis.

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