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Meta-analysis of application of lateral lymph node dissection for low rectal cancer in China
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- Author:
- No author available
- Journal Title:
- World Chinese Journal of Digestology
- Issue:
- 21
- DOI:
- 10.11569/wcjd.v24.i21.3270
- Key Word:
- 直肠癌;侧方淋巴结;复发率;生存率;Rectal cancer;Lateral lymph node;Survival rate;Recurrence rate
Abstract： 目的:评价侧方淋巴结清扫在国内低位直肠癌治疗中应用价值.方法:运用Meta分析的方法对我国2005-01/2015-09公开发表的有关侧方淋巴结清扫在低位直肠癌中应用的1 1篇文献资料进行综合分析.结果:侧方清扫组手术时间明显长于未清扫组,合并加权均数差(weighted mean difference,WMD)为47.79 min,且差异有统计学意义(P＜0.00001).侧方清扫组手术失血量高于未清扫组,合并加权均数差为27.84 mL,且差异有统计学意义(P＜0.0001).侧方淋巴结清扫组5年生存率高于未清扫组(59.8％ vs 51.3％),差异具有统计学意义P＜0.05(P=0.02).侧方淋巴结清扫组三年生存率明显高于未清扫组(81.6％ vs63.5％),差异具有统计学意义(P＜0.00001).侧方淋巴结清扫组的局部复发率明显低于未清扫组(8.4％ vs 16.9％),差异具有统计学意义(P=0.0003).Ⅰ期及ⅡA期行侧方淋巴结清扫对于局部复发的影响差异无统计学意义(PⅠ期=0.96,PⅡA期=0.05).Ⅲ期低位直肠癌侧方淋巴结清扫组局部复发率明显低于未清扫组(14.5％ vs 22.1％),P＜0.05(P=0.0l)差异具有统计学意义.结论:我国低位直肠癌患者行侧方淋巴结清扫能有效的延长患者的5年生存率及3年生存率,降低局部复发率(尤其是Ⅲ期低位直肠癌),改善患者预后,但会增加手术时间及术中出血量.
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