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机器人辅助与传统腹腔镜子宫切除术治疗良性妇科疾病：系统评价与荟萃分析

Robotic-assisted Versus Conventional Laparoscopic Hysterectomy for Benign Gynecological Conditions: A Systematic Review and Meta-analysis.

作者信息

Bahadur Anupama, Zaman Rabia, Mundhra Rajlaxmi, Mani Kalaivani

机构信息

Department of Obstetrics and Gynecology, All India Institute of Medical Sciences, Rishikesh, Uttarakhand, India.

Department of Biostatistics, All India Institute of Medical Sciences, Delhi, India.

出版信息

J Midlife Health. 2024 Apr-Jun;15(2):91-98. doi: 10.4103/jmh.jmh_235_23. Epub 2024 Jul 5.

DOI:10.4103/jmh.jmh_235_23
PMID:39145271
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC11321512/
Abstract

BACKGROUND

Minimally invasive gynecologic surgery is safe and feasible procedure for benign gynaecological conditions with less morbidity.

OBJECTIVE

To determine the best approach in benign gynecology and establish superiority of robotic over conventional laparoscopic hysterectomy in terms of safety and effectiveness.

METHODS

Search strategy: Electronic databases: MEDLINE, Embase, CENTRAL (the Registry of Controlled Clinical Studies of the Cochrane Collaboration), Google scholar, Pubmed and Scopus were searched from 2010-2022. Selection criteria: All randomized controlled trials and quasi-randomised trials which compared robotic versus conventional laparoscopic hysterectomy were included to conduct this systematic review and meta-analysis to investigate compared to traditional approaches.

RESULTS

Only five RCTs (326 patients in total) comparing robotic and conventional laparoscopic hysterectomy were included after a comprehensive literature search. Results of our analysis showed no clear benefit in any of the two techniques in operating time, estimated blood loss, length of hospital stay and overall complications.

CONCLUSION

This systematic review suggests no statistical difference in surgical and patient outcomes between robotic and conventional laparoscopic hysterectomy relating to OT, EBL, LOHS, overall complications, and survival.

摘要

背景

微创妇科手术对于良性妇科疾病而言是安全可行的手术方式，发病率较低。

目的

确定良性妇科疾病的最佳手术方式，并在安全性和有效性方面确立机器人辅助子宫切除术优于传统腹腔镜子宫切除术。

方法

检索策略：检索2010年至2022年的电子数据库，包括MEDLINE、Embase、CENTRAL（Cochrane协作网对照临床研究注册库）、谷歌学术、PubMed和Scopus。纳入标准：所有比较机器人辅助子宫切除术与传统腹腔镜子宫切除术的随机对照试验和半随机试验均纳入本系统评价和荟萃分析，以与传统手术方式进行比较。

结果

全面文献检索后，仅纳入了5项比较机器人辅助子宫切除术和传统腹腔镜子宫切除术的随机对照试验（共326例患者）。我们的分析结果显示，在手术时间、估计失血量、住院时间和总体并发症方面，两种技术均无明显优势。

结论

本系统评价表明，机器人辅助子宫切除术与传统腹腔镜子宫切除术在手术时间、估计失血量、住院时间、总体并发症和生存率方面，手术和患者结局无统计学差异。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/30717424e8dc/JMH-15-91-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/73ac90ac66f5/JMH-15-91-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/9db01e5eb272/JMH-15-91-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/329de517c69d/JMH-15-91-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/37792c60370c/JMH-15-91-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/5aaac5992448/JMH-15-91-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/88bdcbb40cb2/JMH-15-91-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/da5ef899353a/JMH-15-91-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/30717424e8dc/JMH-15-91-g008.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/73ac90ac66f5/JMH-15-91-g001.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/9db01e5eb272/JMH-15-91-g002.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/329de517c69d/JMH-15-91-g003.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/37792c60370c/JMH-15-91-g004.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/5aaac5992448/JMH-15-91-g005.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/88bdcbb40cb2/JMH-15-91-g006.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/da5ef899353a/JMH-15-91-g007.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/e704/11321512/30717424e8dc/JMH-15-91-g008.jpg

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Value of robotic surgery in endometrial cancer by body mass index.机器人手术在不同 BMI 患者子宫内膜癌治疗中的价值。
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