Zhang Oscar, Alzul Robert, Carelli Matheus, Melfi Franca, Tian David, Cao Christopher
School of Clinical Medicine, UNSW Medicine & Health, St. Vincent's Healthcare Clinical Campus, Faculty of Medicine and Health, UNSW Sydney, Sydney, NSW 2010, Australia.
Department of Cardiothoracic Surgery, Royal Prince Alfred Hospital, Sydney University, Sydney, NSW 2050, Australia.
J Pers Med. 2022 Aug 12;12(8):1311. doi: 10.3390/jpm12081311.
(1) Background: Conventional open thoracotomy has been the accepted surgical treatment for resectable non-small cell lung cancer. However, newer, minimally invasive approaches, such as robotic surgery, have demonstrated similar safety and efficacy with potentially superior peri-operative outcomes. The present study aimed to quantitatively assess these outcomes through a meta-analysis. (2) Methods: A systematic review was performed using electronic databases to identify all of the relevant studies that compared robotic surgery with open thoracotomy for non-small cell lung cancer. Pooled data on the peri-operative outcomes were then meta-analyzed. (3) Results: Twenty-two studies involving 12,061 patients who underwent robotic lung resection and 92,411 patients who underwent open thoracotomy were included for analysis. Mortality rates and length of hospital stay were significantly lower in patients who underwent robotic resection. Compared to open thoracotomy, robotic surgery was also associated with significantly lower rates of overall complications, including atrial arrhythmia, post-operative blood transfusions, pneumonia and atelectasis. However, the operative times were significantly longer with robotic lung resection. (4) Conclusions: The present meta-analysis demonstrated superior post-operative morbidity and mortality outcomes with robotic lung resection compared to open thoracotomy for non-small cell lung cancer.
（1）背景：传统开胸手术一直是可切除非小细胞肺癌公认的手术治疗方法。然而，更新的微创方法，如机器人手术，已显示出相似的安全性和有效性，围手术期结果可能更优。本研究旨在通过荟萃分析对这些结果进行定量评估。（2）方法：利用电子数据库进行系统评价，以识别所有比较机器人手术与开胸手术治疗非小细胞肺癌的相关研究。然后对围手术期结果的汇总数据进行荟萃分析。（3）结果：纳入22项研究，共12061例接受机器人肺切除术的患者和92411例接受开胸手术的患者进行分析。接受机器人切除术的患者死亡率和住院时间显著更低。与开胸手术相比，机器人手术还与总体并发症发生率显著降低相关，包括房性心律失常、术后输血、肺炎和肺不张。然而，机器人肺切除术的手术时间显著更长。（4）结论：本荟萃分析表明，与开胸手术相比，机器人肺切除术治疗非小细胞肺癌的术后发病率和死亡率结果更优。
