目的：比较腹腔镜（LPS）与开腹（LPT）在早期卵巢癌全面分期手术中的疗效。方法计算机检索PubMed、EMBase、Cochrane Library、万方数据库、中国生物医学文献数据库、中国知网1990-01-01至2014-02-12有关 LPS 和 LPT 在早期卵巢癌全面分期手术中疗效的文献。采用 RevMan 5.2.9软件对手术时间、术中失血量、淋巴结切除数、术中肿瘤破裂发生率、术后肛门排气时间、手术并发症发生率、术后疼痛评分（VAS）、术后住院时间、术后复发率和术后病死率进行分析。结果共纳入18篇临床对照研究（CCT）文献，包括434例 LPS 患者和788例LPT 患者，文献质量较好。LPS 组较 LPT 组术中失血量少〔 MD ＝-207.86，95％ CI（-285.87，-129.86），P ＜0.05〕，术后肛门排气时间早〔MD ＝-25.26，95％ CI（-31.07，-19.45），P ＜0.05〕，手术并发症发生率低〔OR ＝0.30，95％ CI（0.20，0.45），P ＜0.05〕，术后疼痛轻〔MD ＝-2.84，95％ CI（-4.39，-1.29），P ＜0.05〕，住院时间短〔MD ＝-4.14，95％ CI（-4.63，-3.66），P ＜0.05〕，而两组手术时间、淋巴结切除数、术中肿瘤破裂率、术后复发率、病死率间差异无统计学意义（P ＞0.05）。结论 LPS 下早期卵巢癌全面分期手术创伤小、恢复快，远期效果与 LPT 手术相比无明显差异。%Objective To compare the effects of laparoscopic(LPS)and laparotomy(LPT)on early ovarian cancer in staging operation. Methods PubMed,EMBase,Cochrane Library,Wan - fang database,Chinese Biomedical Abstracts database,China National Knowledge Infrastructure were retrieved for literatures on the effects of LPS,LPT on early ovarian cancer in staging operation from 1990 - 01 - 01 to 2014 - 02 - 12. RevMan 5. 2. 9 software was used to analyze the operative time,intraoperative blood loss,number of lymph node dissection,incidence of intraoperative tumor rupture,postoperative anal exhaust time,incidence of surgical complications,postoperative pain scores(VAS),hospital stay,recurrence rate,mortality. Results A total of 18 controlled clinical studies were enrolled including 434 LPS patients and 788 LPT patients. The blood loss was less in LPS group than in LPT group〔MD = - 207. 86,95% CI( - 285. 87, - 129. 86),P < 0. 05〕,anal exhaust time earlier〔MD = - 25. 26,95% CI( - 31. 07, - 19. 45),P < 0. 05〕,surgical complication incidence lower〔 OR = 0. 30, 95% CI(0. 20,0. 45),P < 0. 05〕,pains fewer〔 MD = - 2. 84,95% CI( - 4. 39, - 1. 29),P < 0. 05〕,hospital stay shorter〔MD = - 4. 14,95% CI( - 4. 63, - 3. 66),P < 0. 05〕,but there were no significant difference in surgical time, number of lymph node dissection,intraoperative tumor rupture,postoperative recurrence rate,mortality between two groups(P> 0. 05). Conclusion Laparoscopic staging operation of early ovarian cancer with small surgical traumas and quick recovery is not remarkably different from LPT.
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