Guo Xinmeng, Tian Shuang, Wang Hui, Zhang Jinning, Cheng Yanfei, Yao Yuanqing
College of Medicine, Nankai University, Tianjin, China.
Department of Obstetrics and Gynecology, Chinese PLA General Hospital, Beijing, China.
Int J Gynaecol Obstet. 2023 Jan;160(1):28-37. doi: 10.1002/ijgo.14209. Epub 2022 Apr 19.
To evaluate the efficacy and safety of five different approaches to cervical cancer surgery.
We conducted a systematic search for comparative studies on different radical hysterectomy types for cervical cancer in PubMed, Embase, the Cochrane Library, and Web of Science databases. All included observational studies used survival analyses to compare clinical outcomes of patients undergoing different radical hysterectomy types. All studies were assessed by the Newcastle-Ottawa Scale with scores of at least seven points. We extracted the relevant data and conducted a network meta-analysis to compare clinical outcomes among five surgical approaches.
Thirty studies (n = 11 353) were included. Robotic surgery had the lowest blood loss volume and hospitalization duration; open surgery had the shortest operative time. Vaginal assisted laparoscopic surgery was associated with the highest number of resected lymph nodes and lowest rate of perioperative complications. Survival outcomes and tumor recurrence outcomes were similar among the approaches.
The current approaches to cervical cancer surgery have comparable efficacies.
评估五种不同宫颈癌手术方法的疗效和安全性。
我们在PubMed、Embase、Cochrane图书馆和科学网数据库中对不同类型宫颈癌根治性子宫切除术的比较研究进行了系统检索。所有纳入的观察性研究均采用生存分析来比较接受不同类型根治性子宫切除术患者的临床结局。所有研究均采用纽卡斯尔-渥太华量表进行评估，得分至少为7分。我们提取了相关数据并进行了网络荟萃分析，以比较五种手术方法的临床结局。
纳入30项研究（n = 11353）。机器人手术的失血量和住院时间最短；开放手术的手术时间最短。阴道辅助腹腔镜手术切除的淋巴结数量最多，围手术期并发症发生率最低。各手术方法的生存结局和肿瘤复发结局相似。
目前的宫颈癌手术方法疗效相当。
