Office of Clinical Quality, Safety and Performance Improvement University of Iowa Hospitals and Clinics, Iowa City, Iowa, USA
Division of General Internal Medicine, Department of Internal Medicine, Carver College of Medicine, Iowa City, Iowa, USA.
Int J Gynecol Cancer. 2019 Mar;29(3):518-530. doi: 10.1136/ijgc-2018-000098.
We performed a systematic review of the literature and meta-analysis of the infectious complications of hysterectomy, comparing robotic-assisted hysterectomy to conventional laparoscopic-assisted hysterectomy.
We searched PubMed, CINAHL, CDSR, and EMBASE through July 2018 for studies evaluating robotic-assisted hysterectomy, laparoscopic-assisted hysterectomy, and infectious complications. We employed random-effect models to obtain pooled OR estimates. Heterogeneity was evaluated with I estimation and the Cochran Q statistic. Pooled ORs were calculated separately based on the reason for hysterectomy (eg, benign uterine diseases, endometrial cancer, and cervical cancer).
Fifty studies were included in the final review for the meta-analysis with 176 016 patients undergoing hysterectomy. There was no statistically significant difference in the number of infectious complication events between robotic-assisted hysterectomy and laparoscopic-assisted hysterectomy (pooled OR 0.97; 95 % CI 0.74 to 1.28). When we performed a stratified analysis, similar results were found with no statistically significant difference in infectious complications comparing robotic-assisted hysterectomy to laparoscopic-assisted hysterectomy among patients with benign uterine disease (pooled OR 1.10; 95 % CI 0.70 to 1.73), endometrial cancer (pooled OR 0.97; 95 % CI 0.55 to 1.73), or cervical cancer (pooled OR 1.09; 95 % CI 0.60 to 1.97).
In our meta-analysis the rate of infectious complications associated with robotic-assisted hysterectomy was no different than that associated with conventional laparoscopic-assisted hysterectomy.
我们对文献进行了系统评价和荟萃分析，比较了机器人辅助子宫切除术与传统腹腔镜辅助子宫切除术的感染并发症。
我们检索了 PubMed、CINAHL、CDSR 和 EMBASE，以评估机器人辅助子宫切除术、腹腔镜辅助子宫切除术和感染并发症的研究。我们采用随机效应模型获得汇总的 OR 估计值。使用 I 估计和 Cochran Q 统计量评估异质性。根据子宫切除术的原因（例如良性子宫疾病、子宫内膜癌和宫颈癌）分别计算汇总 OR。
最终的荟萃分析共纳入 50 项研究，涉及 176016 例接受子宫切除术的患者。机器人辅助子宫切除术与腹腔镜辅助子宫切除术的感染并发症事件数量无统计学显著差异（汇总 OR 0.97；95%CI 0.74 至 1.28）。当我们进行分层分析时，在良性子宫疾病（汇总 OR 1.10；95%CI 0.70 至 1.73）、子宫内膜癌（汇总 OR 0.97；95%CI 0.55 至 1.73）或宫颈癌（汇总 OR 1.09；95%CI 0.60 至 1.97）患者中，机器人辅助子宫切除术与腹腔镜辅助子宫切除术相比，感染并发症也无统计学显著差异。
在我们的荟萃分析中，机器人辅助子宫切除术与传统腹腔镜辅助子宫切除术相关的感染并发症发生率没有差异。
