机器人辅助微创食管切除术与电视辅助微创食管切除术的短期临床结局比较：一项系统评价和荟萃分析

Comparison of short-term clinical outcomes between robot-assisted minimally invasive esophagectomy and video-assisted minimally invasive esophagectomy: a systematic review and meta-analysis.

作者信息

Zheng Chao, Li Xiao-Kun, Zhang Chi, Zhou Hai, Ji Sai-Guang, Zhong Ji-Hong, Xu Yang, Cong Zhuang-Zhuang, Wang Gao-Ming, Wu Wen-Jie, Shen Yi

机构信息

Department of Cardiothoracic Surgery, Jinling Hospital, School of Medicine, Southeast University, Nanjing, China.

Department of Cardiothoracic Surgery, Jinling Hospital, Medical School of Nanjing University, Nanjing, China.

出版信息

J Thorac Dis. 2021 Feb;13(2):708-719. doi: 10.21037/jtd-20-2896.

BACKGROUND

Though robot-assisted minimally invasive esophagectomy (RAMIE) is demonstrated to offer a better visualization and provide a fine dissection of the mediastinal structures to facilitate the complex thoracoscopic operation, the superiorities of RAMIE over MIE have not been well verified. The aim of this study was to explore the actual superiorities through comparing short-term results of RAMIE with that of MIE.

METHODS

PubMed, EMBASE and web of science databases were systematically searched up to September 1, 2020 for case-controlled studies that compared RAMIE with TLMIE.

RESULTS

Fourteen studies were identified, with a total of 2,887 patients diagnosed with esophageal cancer, including 1,435 patients subjected to RAMIE group and 1,452 patients subjected to MIE group. The operative time in RAMIE was still significantly longer than that in MIE group (OR =0.785; 95% CI, 0.618-0.952; P<0.001). The incidence of pneumonia was significantly lower in RAMIE group compared with MIE group (OR =0.677; 95% CI, 0.468-0.979; P=0.038).

CONCLUSIONS

RAMIE has the superiorities over MIE in short-term outcomes in terms of pneumonia and vocal cord palsy. Therefore, RAMIE could be considered as a standard treatment for patients with esophageal cancer.

背景

尽管机器人辅助微创食管切除术（RAMIE）已被证明能提供更好的视野，并能对纵隔结构进行精细解剖以促进复杂的胸腔镜手术，但RAMIE相对于微创食管切除术（MIE）的优势尚未得到充分验证。本研究的目的是通过比较RAMIE和MIE的短期结果来探索其实际优势。

方法

系统检索截至2020年9月1日的PubMed、EMBASE和科学网数据库，以查找比较RAMIE和传统腹腔镜微创食管切除术（TLMIE）的病例对照研究。

结果

共纳入14项研究，总计2887例被诊断为食管癌的患者，其中1435例患者接受RAMIE组手术，1452例患者接受MIE组手术。RAMIE组的手术时间仍显著长于MIE组（OR =0.785；95%CI，0.618 - 0.952；P<0.001）。与MIE组相比，RAMIE组的肺炎发生率显著更低（OR =0.677；95%CI，0.468 - 0.979；P=0.038）。