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1、腹腔镜对比Lichtenstein修补术治疗腹股沟疝的Meta分析［摘要］冃的探讨腹腔镜经腹膜前修补术(transabdoniinalpreperitonealprosthetic,TAPP)或腹腔镜完全腹膜外修补术(totalextraperitonealprosthetic,TEP)对比开放Lichtenstein术治疗腹股沟疝在临床疗效方血有无差异。方法计算机检索CENTRAL(theCochranecentralregisterofcontrolledtrials)>Medline、EMBASE>
2、万方、中国生物医学文献数据库系统(CBM)、中国期刊全文数据库(CNKI)等，搜集国内外公开发表的TAPP或TEP对比开放Lichtenstein术治疗腹股沟疝的临床随机对照研究。应用统计软件Statal1.0和ReviewManager5.0进行数据分析，并根据Cochran手册文献质量评价标准对入选文献进行质量评价。结果最终纳入分析的文章有16篇，腹腔镜组1361例(TAIT组1044例,TEP组317例)，Lichtenstein组1261例,Meta分析的结果显示接受腹腔镜(TAPP/TEP)治疗
3、的患者与接受Lichlenstein患者相比：手术时间明显延长(MD=7.58,95%CT二2.94〜19.51,P<0.001)；两组患者术后并发症发生率无差异(RR二0.97,95%CI二0.84-1.11,P=0.652)；腹腔镜组医疗费用明显高于Lichtenstein组。结论与传统的Lichtenstein术相比，腹腔镜治疗腹股沟疝在临床疗效及成本效益方面并无优势，对于腹股沟疝患者，常规推荐Lichtenstein术治疗。［关键词］腹股沟疝；腹腔镜；Lichtenstein术；Meta分析［中图
4、分类号］R657.8［文献标识码］A［文章编号］1673-9701(2011)25-04-03LaparoscopyComparewithLichtensteininRepairingofAdultInguinalHernia：AMeta~analysisof16RandomisedControlledTrialsWANGXujieTheFirstHospitalofNinghaiCountyinZhejiangProvince,Ninghai315600,China[Abstract]Objective
5、ToexploretheclinicaleffectbetweenlaparoscopyandLichtensteininrepairingofadultinguinalhernia・MethodsComputersearchingCENTRAL(theCochranecentralregisterofcontrolledtrials),Medline,EMBSE,CBM,CNKTandWANFANGetal,wecollectedpublishedrandomizedcontroledtrialsabo
6、utthelaparoscopycomparewithLichtensteininrepairingofadultinguinalhernia・ThedatawasanalysisedbyusingstatisticsoftwareSt.atal1.0.ThemethodologicalqualitywasassessedbyusingCochraneHandbook.ResultsAl116trialswereanaly^edinthemetaanalysis.1361patientswereinthe
7、laparoscopygroupand1261patienlswereintheLichtensteingroup・AsignificantlongeroperationtimewasobservedinthelaparoscopygroupcomparewiththeLichtenstein(MD二7.58,95%CI二2.94-19.51,P<0.01)；Theoverallperioperativecomplicationratewasrelativelyequalbetweenthetwogrou
8、ps(RR=O.97,95%CI二0.84-1.11,P=0.652)；But.themedicalcostwasmuchhigherinthelaparoscopygroupcomparedwithLichtenstein・ConclusionComparedwithtraditionalLichtenstein,laparoscopicsurgeryhasnoadvantageinclinicalefficacyandco
