传统腹腔镜根治性胃切除术与机器人根治性胃切除术后的胰腺并发症：系统评价与Meta分析
Pancreatic Complications After Conventional Laparoscopic Radical Gastrectomy Versus Robotic Radical Gastrectomy: Systematic Review and Meta-Analysis.
作者信息
Guerra Francesco, Giuliani Giuseppe, Formisano Giampaolo, Bianchi Paolo Pietro, Patriti Alberto, Coratti Andrea
机构信息
1 Division of General, Oncological, and Vascular Surgery, Ospedali Riuniti Marche Nord , Pesaro, Italy .
2 Division of Oncological and Robotic General Surgery, Careggi University Hospital , Florence, Italy .
出版信息
J Laparoendosc Adv Surg Tech A. 2018 Oct;28(10):1207-1215. doi: 10.1089/lap.2018.0159. Epub 2018 May 7.
BACKGROUND
Recent reports have suggested that the use of the robot might reduce the rate of pancreatic complications following minimally invasive radical gastrectomy.
METHODS
By meta-analyzing the available literature, we aimed to elucidate possible differences between conventional laparoscopic and robotic radical gastrectomy on pancreatic morbidity.
RESULTS
More than 2000 patients from eight studies were eventually included in the analysis. The overall incidence of postoperative pancreatic complications was 2.2%, being 1.7% and 2.5% following robotic and laparoscopic gastrectomy (LG), respectively. In particular, pancreatic fistula occurred in 2.7% of patients receiving robotic gastrectomy (RG) and 3.8% of patients receiving laparoscopy.
CONCLUSIONS
The use of the robot showed a trend toward better outcomes compared with laparoscopy, despite the presence of more advanced disease and higher body mass index. The meta-analysis resulted in an odd ratio of 0.8 favoring RG over LG on pancreatic morbidity, although without statistical significance.
背景
近期报告表明，使用机器人可能会降低微创根治性胃切除术后胰腺并发症的发生率。
方法
通过对现有文献进行荟萃分析，我们旨在阐明传统腹腔镜根治性胃切除术与机器人根治性胃切除术在胰腺发病率方面可能存在的差异。
结果
最终，八项研究中的2000多名患者被纳入分析。术后胰腺并发症的总体发生率为2.2%，机器人辅助胃切除术和腹腔镜胃切除术（LG）后的发生率分别为1.7%和2.5%。特别是，接受机器人辅助胃切除术（RG）的患者中有2.7%发生胰瘘，接受腹腔镜手术的患者中有3.8%发生胰瘘。
结论
尽管存在更晚期疾病和更高的体重指数，但与腹腔镜手术相比，使用机器人显示出更好的预后趋势。荟萃分析得出，在胰腺发病率方面，支持RG优于LG的优势比为0.8，尽管无统计学意义。
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