Clinical Effectiveness And Safety Of Laparoscopic Surgical Staging In Early-stage Ovarian Cancer: A Meta-analysis

Objective： To assess the Clinical Effectiveness and Safety of LaparoscopicSurgical Staging in Early-Stage Ovarian Cancer,in order to provide a more reasonablebasis in clinical.Methods：According to the search strategy made by Cochrane Collaboration,wesearched Ovid、EMbase、PubMed、CBM、CNKI、WANFANG DATA by using computer.Using―ovarian cancer‖,―ovarian carcinoma‖,―earlystage‖,―laparoscopy‖,―stagingsurgery‖,―staging laparoscopy‖for english search terms,and―fu qiang jing、kai fu shoushu、fen qi shou shu、zao qi luan chao ai、luan chao ai、fu qiang jing fen qi shou shu‖forchinese search terms to search.According to the selected and exclusion standdard,wecollect the related literature.We complete the quality assessment and data extractionindependently with cross-checking. RevMan5.2software was used for meta-analysis.Result： A total of12non-randomized controlled trials involving7chineseliteratures and5english literatures were included,they were the paralleldesign.Generally,12studies involving753patients.There were314cases in laparoscopgroup and439cases in laparotomy group were obtained.No statistically significantdifferences were observed between groups in age,body mass index,clinical stage.Themeta-analysis result showed that:The laparoscopy group had more operation time,lessintraoperative blood loss,,earlier general diet intake,less hospital stay and lessperioperative complications than the laparotomy group.(operation time:WMD=38.2795%CI：10.03～66.51,P=0.008；intraoperative blood loss：WMD=﹣223.29，95%CI：﹣324.09～﹣123.09，P＜0.0001；the analexhaust time：SMD=﹣1.79，95%CI：﹣2.30～﹣1.29，P＜0.00001；hospital stay：WMD=﹣4.87，95%CI：﹣6.70～﹣3.05， P＜0.00001；perioperative complications：OR=0.43，95%CI：0.26～0.71，P=0.0009）；No statistically significant difference was observed between groups inpostoperativerecurrence rat, resecting pelvic lymph node number and para-aortic lymph nodenumber.(postoperative recurrence rate：OR=0.54，95%CI：0.18～1.57，P=0.26，resectionpelvic lymph node number：WMD=﹣1.80，95%CI：﹣3.91～0.32,P=0.10,resectionpara-aortic lymph node number：WMD=1.22，95%CI：-0.81～3.24,P=0.24).Conclusion： Laparoscopy was a effective and safe choice to treat early ovariancancer.Laparoscopy had the advantages of smaller trauma,shorter hospiatal stay,lesspostoperative complications and lower perioperative recurrence rate.However,weobtained literature all were non-randomized controlled trials,and fewer cases.So thisconclusion still needs to be further proved by performing more high-quality studies.