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机器人手术在宫颈癌治疗方面优于传统方法:系统评价和荟萃分析。

Superiority of robotic surgery for cervical cancer in comparison with traditional approaches: A systematic review and meta-analysis.

机构信息

Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China; Department of Obstetrics, The General Hospital of Jinan Military Command, Jinan, PR China.

Department of Obstetrics and Gynecology, PLA General Hospital, Beijing, PR China.

出版信息

Int J Surg. 2017 Apr;40:145-154. doi: 10.1016/j.ijsu.2017.02.062. Epub 2017 Feb 24.

Abstract

OBJECTIVES

To review the safety and effectiveness of da Vinci robotic surgery for cervical cancer in comparison with the traditional open surgery and conventional laparoscopic operation.

METHODS

Based on Medline, the Cochrane library, Embase, and the Journal of Robotic Surgery prior to December 30st, 2015, we searched for controlled trials and observational studies. A systematic review with meta-analyses was conducted to compare the clinical efficacy between the da Vinci robotic surgery, open surgery, and laparoscopic surgery for cervical cancer. Data were pooled using the random effects meta-analysis.

RESULTS

Compared with the open surgery, the robotic surgery for cervical cancer would be advantageous in terms of the length of hospital stay, incidence of complications, volume of blood loss and blood transfusion. The operative time of robotic surgery was longer than that of the open surgery, but the prediction intervals indicated that they could be shorter in future studies. Meanwhile, compared with conventional laparoscopic surgery, the robotic surgery could offer more benefits in terms of the length of hospital stay, while no difference was found in terms of the incidence of complications and the volume of blood loss.

CONCLUSIONS

Compared to open surgery, the robotic surgery would be advantageous for cervical cancer patients in terms of the length of hospital stay, the incidence of complications, blood loss and blood transfusion. Compared with conventional laparoscopic surgery, the robotic surgery would result in longer OT, more BL and shorter LOS. The study quality was poor.

摘要

目的

与传统的开腹手术和传统的腹腔镜手术相比,评估达芬奇机器人手术治疗宫颈癌的安全性和有效性。

方法

基于 Medline、Cochrane 图书馆、Embase 和《机器人外科学杂志》,我们检索了截至 2015 年 12 月 30 日的对照试验和观察性研究。对达芬奇机器人手术、开腹手术和腹腔镜手术治疗宫颈癌的临床疗效进行了系统评价和荟萃分析。使用随机效应荟萃分析对数据进行合并。

结果

与开腹手术相比,达芬奇机器人手术治疗宫颈癌在住院时间、并发症发生率、出血量和输血方面具有优势。机器人手术的手术时间长于开腹手术,但预测区间表明,在未来的研究中,机器人手术的手术时间可能会更短。同时,与传统的腹腔镜手术相比,达芬奇机器人手术在住院时间方面具有更多的优势,而在并发症发生率和出血量方面没有差异。

结论

与开腹手术相比,达芬奇机器人手术在宫颈癌患者的住院时间、并发症发生率、出血量和输血方面具有优势。与传统的腹腔镜手术相比,达芬奇机器人手术的手术时间更长、出血量更多、住院时间更短。研究质量较差。

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