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机器人辅助肝切除术与腹腔镜肝切除术的疗效:一项系统评价与荟萃分析。

Outcomes of robotic vs laparoscopic hepatectomy: A systematic review and meta-analysis.

作者信息

Montalti Roberto, Berardi Giammauro, Patriti Alberto, Vivarelli Marco, Troisi Roberto Ivan

机构信息

Roberto Montalti, Giammauro Berardi, Roberto Ivan Troisi, Department of General and Hepato-Biliary Surgery, Liver Transplantation Service, Ghent University Hospital and Medical School, 9000 Ghent, Belgium.

出版信息

World J Gastroenterol. 2015 Jul 21;21(27):8441-51. doi: 10.3748/wjg.v21.i27.8441.

Abstract

AIM

To perform a systematic review and meta-analysis on robotic-assisted vs laparoscopic liver resections.

METHODS

A systematic literature search was performed using PubMed, Scopus and the Cochrane Library Central. Participants of any age and sex, who underwent robotic or laparoscopic liver resection were considered following these criteria: (1) studies comparing robotic and laparoscopic liver resection; (2) studies reporting at least one perioperative outcome; and (3) if more than one study was reported by the same institute, only the most recent was included. The primary outcome measures were set for estimated blood loss, operative time, conversion rate, R1 resection rate, morbidity and mortality rates, hospital stay and major hepatectomy rates.

RESULTS

A total of 7 articles, published between 2010 and 2014, fulfilled the selection criteria. The laparoscopic approach was associated with a significant reduction in blood loss and lower operative time (MD = 83.96, 95%CI: 10.51-157.41, P = 0.03; MD = 68.43, 95%CI: 39.22-97.65, P < 0.00001, respectively). No differences were found with respect to conversion rate, R1 resection rate, morbidity and hospital stay.

CONCLUSION

Laparoscopic liver resection resulted in reduced blood loss and shorter surgical times compared to robotic liver resections. There was no difference in conversion rate, R1 resection rate, morbidity and length of postoperative stay.

摘要

目的

对机器人辅助肝切除术与腹腔镜肝切除术进行系统评价和荟萃分析。

方法

使用PubMed、Scopus和Cochrane图书馆中央数据库进行系统文献检索。纳入符合以下标准的任何年龄和性别的接受机器人或腹腔镜肝切除术的参与者:(1)比较机器人辅助肝切除术和腹腔镜肝切除术的研究;(2)报告至少一项围手术期结果的研究;(3)如果同一机构报告了多项研究,则仅纳入最新的研究。主要结局指标设定为估计失血量、手术时间、转化率、R1切除率、发病率和死亡率、住院时间和大肝切除率。

结果

共有7篇发表于2010年至2014年的文章符合入选标准。腹腔镜手术方法与失血量显著减少和手术时间缩短相关(MD = 83.96,95%CI:10.51 - 157.41,P = 0.03;MD = 68.43,95%CI:39.22 - 97.65,P < 0.00001)。在转化率、R1切除率、发病率和住院时间方面未发现差异。

结论

与机器人辅助肝切除术相比,腹腔镜肝切除术导致失血量减少和手术时间缩短。在转化率、R1切除率、发病率和术后住院时间方面没有差异。

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