Rodrigues Rodrigo Corvino, Rodrigues Meline Rossetto Kron, Freitas Noélle de Oliveira, Rudge Marilza Vieira Cunha, Lima Silvana Andréa Molina
Postgraduate Program in Clinical Research.
Department of Nursing, São Paulo State University (UNESP), Medical School, Botucatu.
Medicine (Baltimore). 2019 Jun;98(23):e15974. doi: 10.1097/MD.0000000000015974.
Hysterectomy for benign gynecologic diseases, especially dysfunctional uterine bleeding, is one of the most common gynecologic interventions. The uterus can be removed using abdominal, vaginal, laparoscopic, or robotic-assisted laparoscopic hysterectomy. In a robotic-assisted procedure, the surgeon directs the robot while seated at a console in the operating room. This differs from laparoscopic hysterectomy because a "robot" performs the operation, while the surgeon watches a monitor. This systematic review will compare quality of life (QOL) in patients who undergo total robotic-assisted laparoscopic hysterectomy for benign indications and those who undergo conventional laparoscopic surgery.
We will perform a systematic review according to the Cochrane Methodology for randomized controlled trials. The review will include studies reporting use of QOL metrics to assess patients who undergo total hysterectomy for benign indications using robotic-assisted technique or conventional laparoscopic surgery. QOL will be the primary outcome and will be measured using validated instruments. An overall search strategy will be developed and adapted for Embase, MEDLINE, LILACS, and CENTRAL databases. Two reviewers will independently select the eligible studies, assess the risk of bias, and extract the data from included studies. Similar outcomes measured in at least 2 trials will be plotted in the meta-analysis using Review Manager 5.3. The quality of evidence will be determined using the GRADE approach.
This systematic review is designed to provide high quality evidence on QOL in patients undergoing total hysterectomy for benign indications using either robotic-assisted or conventional laparoscopic surgery.
It is expected that high-quality evidence on QOL can be used to guide decision-making by institutions and clinicians to improve health care; the evidence can also be used in future studies.
PROSPERO CRD 42019129913.
因良性妇科疾病，尤其是功能失调性子宫出血而进行的子宫切除术，是最常见的妇科手术之一。子宫可以通过经腹、经阴道、腹腔镜或机器人辅助腹腔镜子宫切除术来切除。在机器人辅助手术中，外科医生坐在手术室的控制台前操控机器人。这与腹腔镜子宫切除术不同，因为是“机器人”进行手术，而外科医生观看监视器。本系统评价将比较因良性指征接受全机器人辅助腹腔镜子宫切除术的患者与接受传统腹腔镜手术的患者的生活质量（QOL）。
我们将根据Cochrane随机对照试验方法进行系统评价。该评价将纳入报告使用生活质量指标来评估因良性指征接受全子宫切除术的患者的研究，这些患者采用机器人辅助技术或传统腹腔镜手术。生活质量将作为主要结局，并使用经过验证的工具进行测量。将制定一个总体检索策略，并针对Embase、MEDLINE、LILACS和CENTRAL数据库进行调整。两名评价者将独立选择符合条件的研究，评估偏倚风险，并从纳入的研究中提取数据。至少在2项试验中测量的相似结局将使用Review Manager 5.3在Meta分析中进行绘制。将使用GRADE方法确定证据质量。
本系统评价旨在提供高质量证据，以说明因良性指征接受全子宫切除术的患者采用机器人辅助或传统腹腔镜手术时的生活质量。
预计关于生活质量的高质量证据可用于指导机构和临床医生的决策，以改善医疗保健；该证据也可用于未来的研究。
PROSPERO注册号：PROSPERO CRD 42019129913。
