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与传统电视辅助胸腔镜手术(VATS)技术相比,机器人手术治疗肺癌的围手术期结果。

Perioperative outcomes of robotic surgery for the treatment of lung cancer compared to a conventional video-assisted thoracoscopic surgery (VATS) technique.

作者信息

Yu Zipu, Xie Qiong, Guo Lei, Chen Xin, Ni Chenyao, Luo Wenzong, Li Weidong, Ma Liang

机构信息

Department of Thoracic Surgery, 2nd Affiliated Hospital, Zhejiang University, Hangzhou, China.

Department of Cardiothoracic Surgery, 1st Affiliated Hospital, Zhejiang University, Hangzhou, China.

出版信息

Oncotarget. 2017 Jul 25;8(53):91076-91084. doi: 10.18632/oncotarget.19533. eCollection 2017 Oct 31.

Abstract

AIM

To conduct a meta-analysis to determine the relative merits between robotic video-assisted thoracoscopic surgery (R-VATS) and conventional video-assisted thoracoscopic surgery (VATS) for lung cancer.

RESULTS

Fifteen studies matched the selection criterion, which reported 8827 subjects, of whom 1704 underwent R-VATS and 7123 underwent VATS. Compared the perioperative outcomes with VATS, reports of R-VATS indicated unfavorable outcomes considering the operative time (SMD = 0.48, 95% CI 0.15 to 0.81). Meanwhile, the number of dissected lymph nodes (SMD = 0.12, 95% CI -0.27 to 0.51) and hospital stay following surgery (SMD = -0.1; 95% CI -0.27 to 0.07), conversion (RR = 0.68; 95% CI 0.42 to 1.11), morbidity (RR = 0.99, 95% CI 0.92 to 1.07) and mortality (RR = 0.33, 95% CI 0.1 to 1.09) were similar for both procedures.

MATERIALS AND METHODS

A literature search was performed to identify comparative studies reporting perioperative outcomes for R-VATS and VATS for lung cancer. Pooled risk ratio (RR) and standardized mean differences (SMDs) with 95% confidence intervals (95% CIs) were calculated using either the fixed effects model or the random effects model.

CONCLUSIONS

There is no difference in terms of perioperative outcomes between R-VATS and VATS except for the operative time which is significantly high for R-VATS. Further studies are required to confirm these results.

摘要

目的

进行一项荟萃分析,以确定机器人电视辅助胸腔镜手术(R-VATS)与传统电视辅助胸腔镜手术(VATS)治疗肺癌的相对优缺点。

结果

15项研究符合选择标准,共报告了8827名受试者,其中1704人接受了R-VATS,7123人接受了VATS。与VATS的围手术期结果相比,R-VATS的报告显示,考虑到手术时间,结果不理想(标准化均数差[SMD]=0.48,95%可信区间[CI]为0.15至0.81)。同时,两组手术的清扫淋巴结数量(SMD=0.12,95%CI为-0.27至0.51)、术后住院时间(SMD=-0.1;95%CI为-0.27至0.07)、中转率(风险比[RR]=0.68;95%CI为0.42至1.11)、发病率(RR=0.99,95%CI为0.92至1.07)和死亡率(RR=0.33,95%CI为0.1至1.09)相似。

材料与方法

进行文献检索,以确定报告R-VATS和VATS治疗肺癌围手术期结果的比较研究。使用固定效应模型或随机效应模型计算合并风险比(RR)和标准化均数差(SMD)以及95%可信区间(95%CI)。

结论

R-VATS和VATS在围手术期结果方面没有差异,除了R-VATS的手术时间明显较长。需要进一步研究来证实这些结果。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e204/5710907/5cb6aa84e0e3/oncotarget-08-91076-g001.jpg

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