Application and research progress of lasers in kidney neoplasm treatment:an intergrated bibliometric and Meta-analysis study
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维普
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目的 通过整合的文献计量学和荟萃分析探讨激光在肾肿瘤治疗中的应用及其研究进展.方法 通过计算机检索Web of Science核心合集和中国知网数据库自建库至2024年6月7日的肾肿瘤和激光的相关文献,将得到的结果进行全面的文献计量学分析.筛选出高质量文献进一步描述激光辅助腹腔镜肾部分切除术的患者特征.运用Rev Man 5.4.1软件对部分研究进行Meta分析,比较激光辅助腹腔镜肾部分切除术治疗前后肾功能的变化,并比较其与传统腹腔镜肾部分切除术疗效的差异.结果 本研究共检索得到549篇激光在肾肿瘤诊疗应用的文献,包括513篇英文文献和36篇中文文献.肾肿瘤和激光领域的年发文量和年引用量基本呈上升趋势,中国发文量领先,位居第2位(100篇,18.2％),激光治疗主要应用于肾肿瘤保肾手术治疗,尤其是腹腔镜肾部分切除术.进一步筛选获得11篇高质量文献,共包含284例接受激光辅助腹腔镜肾部分切除术的肾肿瘤患者.对284例患者的整体临床特征进行描述性分析,所有患者均为T1a期肾肿瘤,肿瘤长径平均值为2.6 cm(0.8～4.0 cm),均为局部单发、外生型肿瘤.Meta分析结果提示,激光辅助腹腔镜肾部分切除术治疗前后患者血清肌酐(MD=4.52,95％CI-9.73～0.69,P=0.09)和估算肾小球滤过率(MD=3.05,95％CI-1.03～7.13,P=0.14)差异均无统计学意义.而激光辅助腹腔镜肾部分切除术较传统腹腔镜肾部分切除术的手术时间显著缩短(MD=-10.58,95％CI-13.11～-8.06,P＜0.01),但术中出血量(MD=-27.09,95％CI-67.38～13.21,P=0.19)和住院时间(MD=-1.59,95％CI-3.42～0.25,P=0.09)差异均无统计学意义.结论 激光在肾肿瘤治疗中的应用正在受到泌尿外科医生的关注和重视,激光辅助肾部分切除术拥有切割、止血等诸多优势,对于外生型T1a期肾肿瘤"零缺血"保肾手术的患者,具良好的临床应用价值.
Objective To explore the application and research progress of lasers in the treatment of kidney neoplasms through an integrated bibliometric and Meta-analysis study.Methods On June 7th,2024,an online search of the Web of Science Core Collection(WoSCC)and China National Knowledge Infrastructure(CNKI)databases for all relevant literature on lasers in kidney neoplasms was conducted.The retrieved results were subjected to a comprehensive bibliometric analysis.The high-quality studies were then screened to further describe the clinical characteristics of patients who underwent laser-assisted laparoscopic partial nephrectomy(LLPN).Subsequently,a Meta-analysis was performed using RevMan 5.4.1 software on further selected high-quality studies to compare the changes in renal function before and after LLPN treatment,and the differences in efficacy between LLPN and traditional laparoscopic partial nephrectomy(LPN).Results Our study obtained a total of 549 publications on lasers in kidney neoplasms,including 513 in English and 36 in Chinese.Bibliometric analysis revealed an overall upward trend in the annual publications and citations in this field.China was found to be a leading contributor ranking second in total publications(n=100,18.2％).The primary application of laser treatment was in nephron-sparing surgery for kidney neoplasms,especially in LPN.We further screened 11 high-quality studies comprising 284 patients who underwent LLPN for kidney neoplasms.Comprehensive descriptive statistical analysis was performed on clinical characteristics of the 284 patients.All patients had T1a stage tumors with a mean tumor length of 2.6 cm(range:0.8-4.0 cm),all being local,solitary,and exophytic tumors.Further Meta-analysis indicated that there were no signifiicant differences in renal function indicators including both serum creatinine levels(MD=4.52,95％CI-9.73-0.69,P=0.09)and estimated glomerular filtration rate(MD=3.05,95％CI-1.03-7.13,P=0.14)before and after LLPN.Additionally,compared to traditional LPN,LLPN showed significantly reduced operative time(MD=-10.58,95％CI=-13.11-8.06,P＜0.001),but no significant differences in estimated blood loss(MD=-27.09,95％CI-67.38-13.21,P=0.19)and hospital stay(MD=-1.59,95％CI-3.42-0.25,P=0.09).Conclusions The application of lasers in managing of kidney neoplasms is arousing increasing attention among urologists.LLPN offers several advantages,including precise cutting and effective hemostasis.This technique demonstrates considerable clinical value for patients with exophytic T1a kidney neoplasms undergoing"zero-ischemia"nephron-sparing surgery.
维普
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