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机器人辅助根治性切除术与开放手术治疗胆管癌的系统评价和荟萃分析。

Robotic-assisted radical resection versus open surgery for cholangiocarcinoma: 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 May 7;18(1):201. doi: 10.1007/s11701-024-01966-y.

Abstract

To compare the clinical efficacy and safety of robot-assisted resection and open surgery for cholangiocarcinoma (CCA). We conducted a comprehensive search of PubMed, the Cochrane Library, and Embase databases for studies comparing treatment for CCA, covering the period from database inception to January 30, 2024. Two researchers will independently screen literature and extract data, followed by meta-analysis using Review Manager 5.3 software. A total of 5 articles with 513 patients were finally included. Among them, 231 in the robotic group, and 282 in the open group. The Meta-analysis revealed that the robotic group had a significant advantage in terms of intraoperative blood loss (MD =  - 101.44, 95% CI - 135.73 to - 67.15, P < 0.05), lymph node harvest(MD = 1.03, 95% CI 0.30- 1.76, P < 0.05) and length of hospital stay(MD =  - 1.92, 95% CI - 2.87 to- 0.97, P < 0.05). However, there were no statistically significant differences between the two groups in terms of transfusion rate (OR = 0.62, 95% CI 0.31-1.23, P > 0.05), R0 resection (OR = 1.49, 95% CI 0.89- 2.50, P > 0.05), 30-day mortality (OR = 1.68, 95% CI 0.43-6.65, P > 0.05) and complications (OR = 0.76, 95% CI 0.30- 1.95, P > 0.05). Robotic-assisted radical resection for CCA is feasible and safe, and its long-term efficacy and oncological outcomes need to be confirmed by further studies.

摘要

比较机器人辅助切除与开腹手术治疗胆管癌(CCA)的临床疗效和安全性。我们对 PubMed、Cochrane 图书馆和 Embase 数据库进行了全面检索,以查找比较 CCA 治疗的研究,时间范围从数据库建立到 2024 年 1 月 30 日。两名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。最终纳入了 5 篇文章,共 513 例患者。其中机器人组 231 例,开腹组 282 例。Meta 分析显示,机器人组在术中出血量(MD=-101.44,95%CI-135.73 至-67.15,P<0.05)、淋巴结清扫(MD=1.03,95%CI0.30-1.76,P<0.05)和住院时间(MD=-1.92,95%CI-2.87 至-0.97,P<0.05)方面具有显著优势。然而,两组在输血率(OR=0.62,95%CI0.31-1.23,P>0.05)、R0 切除率(OR=1.49,95%CI0.89-2.50,P>0.05)、30 天死亡率(OR=1.68,95%CI0.43-6.65,P>0.05)和并发症发生率(OR=0.76,95%CI0.30-1.95,P>0.05)方面无统计学差异。机器人辅助 CCA 根治性切除术是可行和安全的,其长期疗效和肿瘤学结果需要进一步研究证实。

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