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目的评价D2+腹主动脉旁淋巴结清扫(D4)术治疗进展期胃癌的临床疗效与安全性。方法电子检索Cochrane图书馆的Cochrane对照试验注册数据库(2009年第2期),PubMed,MEDLINE,EMBASE,CBM,CNKI,VIP,万方数据资源的D2和D4淋巴结清扫治疗进展期胃癌的相关文献(截至2009年4月)。由2名评价者独立评价并交叉核对纳入研究的质量,对同质研究采用RevMan5.0软件进行Meta分析。结果共纳入有D2和D4淋巴清扫的对照研究4个,包括1120例患者。D2和D4两种淋巴清扫术治疗进展期胃癌,患者术后生存率无统计学意义(P>0.05);两组的5年复发率,术后病死率,手术并发症发生率也无统计学差异(均P>0.05)。结论 D2和D4两种淋巴结清扫术治疗进展期胃癌的临床效果相似。鉴于纳入研究在方法学上的局限性,尚难最后结论。
Objective To evaluate the clinical efficacy and safety of D2 + para-aortic lymph node dissection (D4) in the treatment of advanced gastric cancer. Methods The Cochrane Central Register of Controlled Trials (No.2 2009 issue), PubMed, MEDLINE, EMBASE, CBM, CNKI, VIP, and Cochrane Central Register of Controlled Trials in the Cochrane Library were electronically searched for D2 and D4 lymph node dissections for advanced gastric cancer As of April 2009). Two reviewers independently evaluated and cross-checked the quality of the included studies, and Meta-analysis was performed on the same-sex study using RevMan 5.0 software. Results A total of 4 controlled trials of D2 and D4 lymphadenectasis were included, including 1120 patients. D2 and D4 two kinds of lymphadenectomy for advanced gastric cancer, postoperative survival rate was not statistically significant (P> 0.05); two groups of 5-year recurrence rate, postoperative mortality, the incidence of surgical complications nor statistical Difference (all P> 0.05). Conclusion The clinical effects of D2 and D4 lymphadenectomy for advanced gastric cancer are similar. Given the methodological limitations of incorporating studies, it is still difficult to conclude.