The First Clinical Medical College, Gansu University of Chinese Medicine, Lanzhou, China.
Obstetrics and Gynecology, Gansu Maternal and Child Health Hospital, Lanzhou, China.
World J Surg Oncol. 2023 Jul 28;21(1):230. doi: 10.1186/s12957-023-03104-8.
Systematic evaluation of the efficacy and safety of robotic-assisted laparoscopic myomectomy (RALM) versus laparoscopic myomectomy (LM).
PubMed, Embase, The Cochrane Library, and Web of Science database were searched by computer to seek relevant literature in order to compare the efficacy and safety of RALM with that of LM from the establishment of the databases to January 2023, and Review Manager 5.4 software was utilized to perform a meta-analysis on the literature.
A total of 15 retrospective clinical controlled studies were included. There exists a total of 45,702 patients, among 11,618 patients in the RALM group and the remaining 34,084 patients in the LM group. Meta-analysis results revealed that RALM was associated with lesser intraoperative bleeding (MD = - 32.03, 95%CI - 57.24 to - 6.83, P = 0.01), lower incidence of blood transfusions (OR = 0.86, 95%CI 0.77 to 0.97, P = 0.01), shorter postoperative hospital stay (MD = - 0.11, 95%CI - 0.21 to - 0.01, P = 0.03), fewer transitions to open stomach (OR = 0.82, 95%CI 0.73 to 0.92, P = 0.0006), and lower incidence of postoperative complications (OR = 0.58, 95%CI 0.40 to 0.86, P = 0.006) than LM, whereas LM is more advantageous in terms of operative time (MD = 38.61, 95%CI 19.36 to 57.86, P < 0.0001). There was no statistical difference between the two surgical methods in terms of maximum myoma diameter (MD = 0.26, 95%CI - 0.17 to 0.70, P = 0.24).
In the aspects of intraoperative bleeding, lower incidence of blood transfusions, postoperative hospital stay, transit open stomach rate, and postoperative complications, RALM has a unique advantage than that of LM, while LM has advantages over RALM in terms of operative time.
系统评价机器人辅助腹腔镜子宫肌瘤剔除术（RALM）与腹腔镜子宫肌瘤剔除术（LM）的疗效和安全性。
计算机检索 PubMed、Embase、The Cochrane Library 和 Web of Science 数据库，从建库至 2023 年 1 月，查找比较 RALM 与 LM 疗效和安全性的相关文献，采用 Review Manager 5.4 软件进行 Meta 分析。
共纳入 15 项回顾性临床对照研究，总计 45702 例患者，RALM 组 11618 例，LM 组 34084 例。Meta 分析结果显示，RALM 术中出血量少于 LM[MD=-32.03，95%CI（-57.24，-6.83），P=0.01]，输血率低于 LM[OR=0.86，95%CI（0.77，0.97），P=0.01]，术后住院时间短于 LM[MD=-0.11，95%CI（-0.21，-0.01），P=0.03]，中转开腹率低于 LM[OR=0.82，95%CI（0.73，0.92），P=0.0006]，术后并发症发生率低于 LM[OR=0.58，95%CI（0.40，0.86），P=0.006]，但手术时间长于 LM[MD=38.61，95%CI（19.36，57.86），P<0.0001]。两种术式的肌瘤最大直径[MD=0.26，95%CI（-0.17，0.70），P=0.24]差异无统计学意义。
在术中出血量、输血率、术后住院时间、中转开腹率、术后并发症方面，RALM 较 LM 具有独特优势，而在手术时间方面，LM 优于 RALM。
