机器人肝手术的最新技术:荟萃分析。

State of the art in robotic liver surgery: a meta-analysis.

机构信息

The Second Department of Hepatopancreatobiliary Surgery, The First Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.

Department of Hepatobiliary Surgery, The Fourth Medical Center, Chinese People's Liberation Army General Hospital, Beijing, China.

出版信息

Updates Surg. 2021 Jun;73(3):977-987. doi: 10.1007/s13304-020-00906-3. Epub 2020 Nov 4.

Abstract

Although the number of robotic hepatectomy (RH) performed is increasing, few studies have reported its efficacy in comparison with the conventional surgical modalities. The aim of this meta-analysis was to evaluate the perioperative results of RH vs. open hepatectomy (OH) and RH vs. laparoscopic hepatectomy (LH). We systematically searched for English papers published in PubMed (Medline), Embase, and Cochrane library before March 1, 2020. A total of 39 papers and 2999 patients were eventually included. Among the included patients, 1249, 1010, and 740 underwent RH, LH, and OH, respectively. Compared with OH, the operation time was significantly increased but the intraoperative blood loss, blood transfusion rate, incidence of severe complications, and length of postoperative hospitalization were significantly reduced in patients with RH. However, there was no significant difference in the use of Pringle maneuver and overall incidence of complications. Compared with LH, the operation time was significantly increased, and the intraoperative blood loss was also more in RH. However, there were no differences in blood transfusion rate, use of Pringle maneuver, incidence of complications, incidence of severe complications, and length of postoperative hospitalization between the two groups. A longer operation time remains the main shortcoming of RH. However, based on the perioperative clinical efficacy, we conclude that RH is comparable to LH but is better than OH for selected patients.

摘要

尽管机器人肝切除术 (RH) 的数量在增加,但很少有研究报告其与传统手术方式相比的疗效。本荟萃分析的目的是评估 RH 与开腹肝切除术 (OH) 和 RH 与腹腔镜肝切除术 (LH) 的围手术期结果。我们系统地检索了 2020 年 3 月 1 日之前在 PubMed (Medline)、Embase 和 Cochrane 图书馆发表的英文文献。最终纳入了 39 篇论文和 2999 名患者。在纳入的患者中,分别有 1249、1010 和 740 名患者接受了 RH、LH 和 OH。与 OH 相比,RH 组的手术时间明显增加,但术中出血量、输血率、严重并发症发生率和术后住院时间明显减少。然而,两组的普雷灵操作使用率和总并发症发生率无显著差异。与 LH 相比,RH 组的手术时间明显增加,术中出血量也更多。然而,两组之间的输血率、普雷灵操作使用率、并发症发生率、严重并发症发生率和术后住院时间均无差异。手术时间较长仍然是 RH 的主要缺点。然而,基于围手术期的临床疗效,我们得出结论,对于选定的患者,RH 与 LH 相当,但优于 OH。

文献AI研究员

20分钟写一篇综述,助力文献阅读效率提升50倍

立即体验

用中文搜PubMed

大模型驱动的PubMed中文搜索引擎

马上搜索