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机器人辅助与腹腔镜肾上腺切除术治疗嗜铬细胞瘤的临床疗效和安全性比较:系统评价和荟萃分析。

Comparison of clinical efficacy and safety between robotic-assisted and laparoscopic adrenalectomy for pheochromocytoma: a systematic review and meta-analysis.

机构信息

Affiliated Hospital of North Sichuan Medical College, Nanchong City, 637000, Sichuan Province, China.

出版信息

J Robot Surg. 2024 Mar 11;18(1):115. doi: 10.1007/s11701-024-01846-5.

Abstract

To compare the clinical efficacy and safety of robot-assisted adrenalectomy (RA) and laparoscopic adrenalectomy (LA) for pheochromocytoma (PHEO). We conducted a comprehensive search of PubMed, the Cochrane Library, and Embase databases for studies comparing RA and LA treatment for PHEO, covering the period from database inception to January 1, 2024. Two researchers will independently screen literature and extract data, followed by meta-analysis using Review Manager 5.3 software. Six studies with 658 patients were included in the analysis. There were no significant differences in operation time [MD = -8.03, 95% CI (-25.68,9.62), P > 0.05], transfusion rate [OR = 1.10, 95% CI (0.55, 2.19) , P > 0.05], conversion rate [OR = 0.31, 95% CI (0.08, 1.12), P > 0.05], complication rate [OR = 0.93, 95% CI (0.52, 1.70), P > 0.05], Intraoperative max SBP [MD = -4.08, 95% CI (-10.13,1.97), P > 0.05], Intraoperative min SBP [MD = -2.71, 95% CI (-9.60,4.18), P > 0.05] among patients undergoing RA and LA. However, compared with patients who underwent LA, patients who underwent RA had less estimated blood loss [MD = -37.72, 95% CI (-64.11,-11.33), P < 0.05], a shorter length of hospital stay [MD = -0.43, 95% CI (-0.65,-0.21) P < 0.05]. RA has higher advantages in some aspects compared to LA. RA is a feasible, safe, and comparable treatment option for PHEO.

摘要

比较机器人辅助肾上腺切除术(RA)和腹腔镜肾上腺切除术(LA)治疗嗜铬细胞瘤(PHEO)的临床疗效和安全性。我们全面检索了 PubMed、Cochrane 图书馆和 Embase 数据库中比较 RA 和 LA 治疗 PHEO 的研究,检索时间截至 2024 年 1 月 1 日。两位研究人员将独立筛选文献并提取数据,然后使用 Review Manager 5.3 软件进行荟萃分析。纳入 6 项研究共 658 例患者。两组患者的手术时间[MD=-8.03,95%CI(-25.68,9.62),P>0.05]、输血率[OR=1.10,95%CI(0.55,2.19),P>0.05]、中转率[OR=0.31,95%CI(0.08,1.12),P>0.05]、并发症发生率[OR=0.93,95%CI(0.52,1.70),P>0.05]、术中最大收缩压[MD=-4.08,95%CI(-10.13,1.97),P>0.05]、术中最小收缩压[MD=-2.71,95%CI(-9.60,4.18),P>0.05]差异均无统计学意义。与 LA 组相比,RA 组患者的估计失血量更少[MD=-37.72,95%CI(-64.11,-11.33),P<0.05],住院时间更短[MD=-0.43,95%CI(-0.65,-0.21),P<0.05]。与 LA 相比,RA 在某些方面具有更高的优势。RA 是治疗 PHEO 的一种可行、安全且可比较的治疗选择。

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