The Efficacy And Safety Of Extraperitoneal And Transperitoneal Laparoscopic Para-aortic Lymphadenectomy For Gynecologic Malignancies:a Meta-analysis

Objective:To compare the efficacy and safety of extraperitoneal and transperitoneal laparoscopic para-aortic lymphadenectomy for gynecologic malignancies by Meta-analysis.Methods:Prospective randomized controlled studies or well-designed non-randomized controlled studies about extraperitoneal and transperitoneal laparoscopic para-aortic lymphadenectomy for gynecologic malignancies published between August 2009 and August 2019 were retrieved.The search databases included PubMed,Embase,Cochrane Library,Ovid,Central,cnki,wanfang and Chinese medical literature databases.Extract the data and use Review Manager 5.3 software to analyze the data.Results:Through retrieval,a total of 270 articles were retrieved,and 10 articles were finally included.By comparison,no statistically significant difference between transperitoneal approach group and extraperitoneal approach group were observed in operation time,resection of lymph node number,conversion rate,blood transfusion rate,intraoperative complications and postoperative complications about laparoscopic para-aortic lymphadenectomy for gynecologic malignancies.Extraperitoneal approach group in intraoperative blood loss,hospital stay,postoperative peritoneal lymphatic cyst incidence were less than the transperitoneal approach group,respectively [95% CI(85.36 ~8.19),P = 0.02],[95% CI(1.77 ~ 0.14),P = 0.02],[95% CI(0.34 ~ 0.87),P = 0.01),the difference was statistically significant.Conclusion:Both the extraperitoneal approach have good efficacy and safety about laparoscopic para-aortic lymphadenectomy for gynecologic malignancies with transperitoneal approach,worthy of clinical popularization.