子宫内膜异位症患者的机器人手术与腹腔镜手术对比：一项系统评价与荟萃分析

Robotic surgery vs laparoscopic surgery in patients with diagnosis of endometriosis: a systematic review and meta-analysis.

作者信息

Restaino Stefano, Mereu Liliana, Finelli Angelo, Spina Maria Roberta, Marini Giulia, Catena Ursula, Turco Luigi Carlo, Moroni Rossana, Milani Michela, Cela Vito, Scambia Giovanni, Fanfani Francesco

机构信息

Fondazione Policlinico Universitario A. Gemelli IRCCS, UOC di Ginecologia Oncologica, Dipartimento per la Tutela della Salute della Donna e della Vita Nascente, L.go A. Gemelli, 00167, Rome, Italy.

Division of Gynecological Oncology, Department of Obstetric and Gynecology, Fondazione Policlinico Universitario A. Gemelli IRCCS, L.go A. Gemelli, 00167, Rome, RM, Italy.

出版信息

J Robot Surg. 2020 Oct;14(5):687-694. doi: 10.1007/s11701-020-01061-y. Epub 2020 Mar 7.

DOI:10.1007/s11701-020-01061-y

PMID:32146573

Abstract

Endometriosis is one of the most common medical conditions affecting the women. The study aimed to evaluate the safety and efficacy of robotic-assisted laparoscopic surgery (RAS) versus conventional laparoscopic surgery (LPS) in the treatment of endometriosis. PubMed, Embase, Cochrane and CINAHL databases were searched from January 1995 to March 2019. According to meta-analysis criteria, five comparative studies were selected. A total of 1527 patients were identified. In the meta-analysis, there were no significant differences in blood loss, complication, and hospital stay between RAS and LPS surgeries in the treatment of patients with endometriosis. However, RAS surgery required a higher weighted mean operating time than LPS surgery, 0.54 (95% confidence interval; 0.37 to 0.70; p < 0.00001) min. This meta-analysis confirmed that the robotic surgery is safe and feasible in patients affected by endometriosis. We could suggest that RAS is a valid option and might be considered an alternative to LPS especially in advanced cases.

摘要

子宫内膜异位症是影响女性的最常见病症之一。该研究旨在评估机器人辅助腹腔镜手术（RAS）与传统腹腔镜手术（LPS）治疗子宫内膜异位症的安全性和有效性。检索了1995年1月至2019年3月期间的PubMed、Embase、Cochrane和CINAHL数据库。根据荟萃分析标准，选择了五项比较研究。共纳入1527例患者。荟萃分析结果显示，在治疗子宫内膜异位症患者时，RAS手术与LPS手术在失血量、并发症和住院时间方面无显著差异。然而，RAS手术的加权平均手术时间比LPS手术长0.54分钟（95%置信区间：0.37至0.70；p < 0.00001）。该荟萃分析证实，机器人手术对于患有子宫内膜异位症的患者是安全可行的。我们认为RAS是一种有效的选择，尤其在晚期病例中，可被视为LPS的替代方案。