消融适合小肾脏吗？荟萃分析
Is Ablation Suitable For Small Renal Masses? A Meta-Analysis
影响因子:3.90000
分区:医学2区 / 核医学2区
发表日期:2025 Jan
作者:
Si Ge, Zuoping Wang, Yunxiang Li, Lei Zheng, Lijian Gan, Zhiqiang Zeng, Chunyang Meng, Kangsen Li, Jiakai Ma, Deyu Wang, Yuan Ren
摘要
为了比较小肾脏（SRMS）的消融和部分肾切除术的围手术期和肿瘤学结局。我们严格按照PRISMA标准进行了此荟萃分析，并且质量评估遵循AMSTAR标准。系统地搜索了四个数据库，Embase，PubMed，Cochrane库和科学网络。搜索时间范围从数据库创建到2023年11月。STA16统计软件用于统计分析。加权平均差异（WMD）代表连续性变量，几率或相对风险（或/RR）代表二分法变量，并计算了95％的置信区间（95％CI）。总共27项研究，包括6030名患者。结果表明，接受部分肾脏切除术的患者年轻（WMD = -5.45岁，95％CI [-7.44，-3.46]，-3.46]，p <0.05），手术时间更长（WMD = 64.91分钟，95％CI，95％CI [44.47，85.34]，P <0.05），P <0.05），有更长的时间（wmd of Stay of Stay of Stay of Stay of Stay of Stay of Stays（wmd）。 3.78]，p <0.05），并且估计失血量更高（WMD = 97.76 ml，95％CI [69.48，126.04]。p <0.05）。总体并发症率较高（OR = 1.84，95％CI CI [1.48，2.29]，P <0.05），P <0.05），较高的速率（1.3％），或= 1.3％（或= 1.198）（或= 1.198，或= 1. 1. 198，或= 1.198，或= 1. 1. 1. 1. 1. 1. 198，（或2.88]，p <0.05），复发率较低（OR = 0.32，95％Cl [0.20，0.50]，p <0.05）。 However, there were no differences between ablation and partial nephrectomy in cancer-specific survival (CSS) (HR = 2.07, 95%CI [0.61, 7.04], P > 0.05), overall survival (OS) (HR = 1.24, 95%CI [0.58, 2.65], P > 0.05), and recurrence-free survival (RFS) (HR = 2.68, 95％CI [0.91，7.88]，p> 0.05）。接受部分肾切除术的患者年轻，工作时间和停留时间更长，并且并发症率更高。但是，部分肾切除术和消融之间的CSS，OS和RF没有显着差异，但是需要更精确的高质量研究来证实这一点。
Abstract
To compare perioperative and oncology outcomes of ablation and partial nephrectomy in small renal masses (SRMs).We conduct this meta-analysis strictly according to the PRISMA standard, and the quality evaluation follows the AMSTAR standard. Four databases, Embase, PubMed, Cochrane Library, and Web of Science, were systematically searched. The search time range is from database creation to November 2023. Stata16 statistical software was used for statistical analysis. Weighted mean difference (WMD) represented continuity variables, odds ratio or relative risk (OR/RR) represented dichotomies variables, and 95% confidence intervals (95%CI) were calculated.A total of 27 studies, including 6030 patients. Results showed that patients undergoing partial nephrectomy were younger (WMD = -5.45 years, 95%CI [-7.44, -3.46], P < 0.05), had longer operation time (WMD = 64.91 min, 95%CI [44.47, 85.34], P < 0.05), had longer length of stay (WMD = 2.91 days, 95%CI [2.04, 3.78], P < 0.05), and had more estimated blood loss (WMD = 97.76 ml, 95%CI [69.48, 126.04]. P < 0.05), the overall complication rate was higher (OR = 1.84, 95%CI [1.48, 2.29], P < 0.05), the major complication rate was higher (OR = 1.98, 95%CI [1.36, 2.88], P < 0.05), and the recurrence rate was lower (OR = 0.32, 95%Cl [0.20, 0.50], P < 0.05). However, there were no differences between ablation and partial nephrectomy in cancer-specific survival (CSS) (HR = 2.07, 95%CI [0.61, 7.04], P > 0.05), overall survival (OS) (HR = 1.24, 95%CI [0.58, 2.65], P > 0.05), and recurrence-free survival (RFS) (HR = 2.68, 95%CI [0.91, 7.88], P > 0.05).Patients undergoing partial nephrectomy are younger, have longer operation time and length of stay, and have higher complication rate. However, there was no significant difference in CSS, OS, and RFS between partial nephrectomy and ablation, but more well-designed, high-quality studies are needed to confirm this.