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机器人辅助与腹腔镜胃切除术短期结局的Meta分析

Meta-analysis of the short-term outcomes of robotic-assisted compared to laparoscopic gastrectomy.

作者信息

Chuan Li, Yan Shi, Pei-Wu Yu

机构信息

Department of General Surgery and Center of Minimal Invasive Gastrointestinal Surgery Southwest Hospital, PLA General Surgery Center, The Third Military Medical University , Chongqing , China.

出版信息

Minim Invasive Ther Allied Technol. 2015 Jun;24(3):127-34. doi: 10.3109/13645706.2014.985685. Epub 2014 Dec 3.

Abstract

OBJECTIVE

To compare the short-term outcomes of gastric cancer patients treated with robotic gastrectomy (RG) or laparoscopic gastrectomy (LG).

INTRODUCTION

Robotic gastrectomy (RG) has been used for gastric cancer since 2002. This meta-analysis evaluates the safety and efficacy of robotic gastrectomy (RG) and conventional laparoscopic gastrectomy (LG) for gastric cancer.

MATERIAL AND METHODS

Pubmed, Embase and The Cochrane Library were searched, and manual searches were performed up to March 31, 2013. Five non-randomized control trials that reported RG and LG for gastric cancer were included. Outcomes evaluated were operation time, number of retrieved LN, blood loss, the length of the resection margin, complications, length of postoperative hospital stay.

RESULTS

Of 1796 patients in five studies, 551 were allocated to RG and 1245 to LG. Operation time was significantly shorter in the latter group (weighted mean difference 42.9; 95 % confidence interval 20.87 to 64.92 min; p < 0.05). Blood loss weighted mean difference was -16.07 (95 % confidence interval -32.78 to 0.64 mL; p < 0.05) and postoperative stay weighted mean difference was -1.98 (95 % confidence interval -3.66 to -0.3 days; p < 0.05); both were less in the RG group. LN, length of the resection margin, and postoperative complications were similar in both groups.

CONCLUSION

It may be concluded that RG is a safe and comfortable alternative to LG and is justifiable in the light of clinical trials.

摘要

目的

比较接受机器人胃癌切除术(RG)或腹腔镜胃癌切除术(LG)治疗的胃癌患者的短期疗效。

引言

自2002年以来,机器人胃癌切除术(RG)已被用于治疗胃癌。本荟萃分析评估了机器人胃癌切除术(RG)和传统腹腔镜胃癌切除术(LG)治疗胃癌的安全性和有效性。

材料与方法

检索了PubMed、Embase和Cochrane图书馆,并进行了手动检索,检索截止到2013年3月31日。纳入了5项报告了RG和LG治疗胃癌的非随机对照试验。评估的结果包括手术时间、清扫淋巴结数量、失血量、切缘长度、并发症、术后住院时间。

结果

五项研究中的1796例患者中,551例被分配接受RG,1245例接受LG。后一组的手术时间明显更短(加权平均差42.9;95%置信区间20.87至64.92分钟;p<0.05)。失血量加权平均差为-16.07(95%置信区间-32.78至0.64毫升;p<0.05),术后住院时间加权平均差为-1.98(95%置信区间-3.66至-0.3天;p<0.05);两者在RG组中均较少。两组的淋巴结、切缘长度和术后并发症相似。

结论

可以得出结论,RG是LG的一种安全且舒适的替代方法,根据临床试验是合理的。

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