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机器人辅助根治性膀胱切除术能否为患者提供更小的创伤和更快的康复期?一项比较试验的系统评价和荟萃分析。

Can robotic-assisted radical cystectomy provide patients with a smaller trauma and faster recovery period? A systematic review and meta-analysis of comparative trials.

机构信息

Department of Urology, Nanchong Central Hospital, The Second Clinical College, North Sichuan Medical College (University), Nanchong, 63700, Sichuan, People's Republic of China.

Department of Urology, Institute of Urology, West China Hospital, Sichuan University, Chengdu, 610041, People's Republic of China.

出版信息

J Cancer Res Clin Oncol. 2020 Jun;146(6):1591-1601. doi: 10.1007/s00432-020-03183-0. Epub 2020 Mar 17.

Abstract

OBJECTIVE

This article explores the differences in the effectiveness and safety of the treatment of bladder cancer (BC) by robotic-assisted radical cystectomy (RARC) and laparoscopic radical cystectomy (LRC).

METHODS

A systematic search was performed using databases including Medline, PubMed and Web of Science within a limited period from January 1, 2000, to September 1, 2019. RevMan 5.3 was used for calculation and statistical analyses.

RESULTS

We performed meta-analysis on operation time, estimated blood loss, intraoperative blood transfusion, positive surgical margin, oral intake time, length of hospital stay, complication and other indicators, and found that there were no statistically significant differences between LRC and RARC.

CONCLUSION

Our meta-analysis results show that LRC and RARC have similar results on the effectiveness and safety of BC. For those medical institutions that cannot perform robot-assisted surgery but are seeking minimally invasive and faster postoperative recovery, LRC is worth considering. However, a larger sample size, more rigorous design and longer follow-up randomized controlled trials are still needed to support our conclusions.

摘要

目的

本文探讨了机器人辅助根治性膀胱切除术(RARC)与腹腔镜根治性膀胱切除术(LRC)治疗膀胱癌(BC)的有效性和安全性差异。

方法

在 2000 年 1 月 1 日至 2019 年 9 月 1 日期间,使用 Medline、PubMed 和 Web of Science 等数据库进行系统检索,并进行了限定时间段的搜索。使用 RevMan 5.3 进行计算和统计分析。

结果

我们对手术时间、估计出血量、术中输血、阳性手术切缘、开始口服时间、住院时间、并发症等指标进行了荟萃分析,发现 LRC 和 RARC 之间在这些方面没有统计学差异。

结论

我们的荟萃分析结果表明,LRC 和 RARC 在 BC 的有效性和安全性方面具有相似的结果。对于那些无法进行机器人辅助手术但寻求微创和更快术后恢复的医疗机构,LRC 是值得考虑的。然而,仍需要更大的样本量、更严格的设计和更长的随访随机对照试验来支持我们的结论。

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