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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.

DOI:10.1007/s11701-024-01966-y
PMID:38713337
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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本文引用的文献

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Optimizing robotic thyroid surgery: lessons learned from an retrospective analysis of 104 cases.优化机器人甲状腺手术:104 例回顾性分析的经验教训。
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Concomitant training in robotic and laparoscopic liver resections of low-to-intermediate difficulty score: a retrospective analysis of the learning curve.同期进行低-中难度评分的机器人和腹腔镜肝切除术训练:学习曲线的回顾性分析。
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The optimal number of examined lymph nodes for accurate staging of intrahepatic cholangiocarcinoma: A multi-institutional analysis using the nodal staging score model.用于准确分期肝内胆管癌的最佳检查淋巴结数量:使用淋巴结分期评分模型的多机构分析。
Eur J Surg Oncol. 2023 Aug;49(8):1429-1435. doi: 10.1016/j.ejso.2023.03.221. Epub 2023 Mar 23.
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Hepatology. 2023 Feb 1;77(2):659-702. doi: 10.1002/hep.32771. Epub 2022 Oct 20.
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Robotic versus open pancreaticoduodenectomy for distal cholangiocarcinoma: a multicenter propensity score-matched study.机器人与开腹胰十二指肠切除术治疗远端胆管癌的比较:一项多中心倾向评分匹配研究。
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