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白种人患者机器人与腹腔镜腹股沟疝修补术的比较:系统评价与荟萃分析

Comparison between robotic and laparoscopic inguinal hernia repair in Caucasian patients: a systematic review and meta-analysis.

作者信息

Zhao Fenglin, Wang Baoshan, Chen Jie

机构信息

Department of Hernia and Abdominal Wall Surgery, Beijing Chao-Yang Hospital, Beijing, China.

出版信息

Ann Transl Med. 2021 May;9(10):885. doi: 10.21037/atm-21-2126.

Abstract

BACKGROUND

Laparoscopic and robotic techniques allow surgeons to dissect and observe the groin area from the inside out, this study was to evaluate and compare the effects and safety of robotic inguinal hernia repair (R-IHR) and laparoscopic inguinal hernia repair (L-IHR) in Caucasian patients.

METHODS

We searched the full texts of studies comparing R-IHR and L-IHR in multiple databases. Meta-, sensitivity, and bias analyses of the included literature were performed with Review Manager 5.2, and forest plots were drawn. The joint estimate of the risk ratio (RR) and the mean difference (MD) of the 95% confidence interval (CI) was used as a measure of the effect size.

RESULTS

This meta-analysis included 8 eligible studies involving 1,379 Caucasian patients with inguinal hernia (IH). No significant difference was found in pain score (MD =1.52, 95% CI, -0.30, 3.35, P=0.10; I=97%), length of hospital stay (MD =0.14, 95% CI, -0.03, 0.30, P for overall effect =1.63, I=0%), or complications (RR =1.24 with 95% CI, 0.94, 1.63, P for overall effect =0.13, I=0%) between R-IHR and L-IHR. However, there was significant difference in operative time between R-IHR and L-IHR (MD =17.17, 95% CI, 6.32, 28.03, P=0.002; I=84%).

DISCUSSION

This meta-analysis revealed only minor differences between R-IHR and L-IHR in terms of clinical effects and safety in Caucasian patients, although R-IHR has a longer operative time than L-IHR. Both R-IHR and L-IHR are suitable to treat Caucasian patients with IH.

摘要

背景

腹腔镜和机器人技术使外科医生能够从内部向外解剖和观察腹股沟区域,本研究旨在评估和比较机器人腹股沟疝修补术(R-IHR)和腹腔镜腹股沟疝修补术(L-IHR)在白种人患者中的效果和安全性。

方法

我们在多个数据库中检索了比较R-IHR和L-IHR的研究全文。使用Review Manager 5.2对纳入文献进行荟萃分析、敏感性分析和偏倚分析,并绘制森林图。风险比(RR)和95%置信区间(CI)的平均差(MD)的联合估计值用作效应大小的衡量指标。

结果

这项荟萃分析纳入了8项符合条件的研究,涉及1379例白种人腹股沟疝(IH)患者。R-IHR和L-IHR在疼痛评分(MD =1.52,95% CI,-0.30,3.35,P =0.10;I² =97%)、住院时间(MD =0.14,95% CI,-0.03,0.30,总体效应P =1.63,I² =0%)或并发症(RR =1.24,95% CI,0.94,1.63,总体效应P =0.13,I² =0%)方面未发现显著差异。然而,R-IHR和L-IHR之间的手术时间存在显著差异(MD =17.17,95% CI,6.32,28.03,P =0.002;I² =84%)。

讨论

这项荟萃分析表明,尽管R-IHR的手术时间比L-IHR长,但在白种人患者的临床效果和安全性方面,R-IHR和L-IHR之间仅存在微小差异。R-IHR和L-IHR均适用于治疗白种人IH患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/63e1/8184425/a2176a7669a1/atm-09-10-885-f1.jpg

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