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肥胖患者机器人辅助与腹腔镜肾上腺切除术的全面回顾和荟萃分析。

A comprehensive review and meta-analysis comparing robot-assisted and laparoscopic adrenalectomy in individuals with obesity.

机构信息

North Sichuan Medical College, Nanchong, China.

Department of Urinary Surgery, The General Hospital of Western Theater Command, Chengdu, China.

出版信息

J Robot Surg. 2024 Aug 28;18(1):331. doi: 10.1007/s11701-024-02084-5.

Abstract

This meta-analysis aimed to compare the efficacy of robot-assisted vs. laparoscopic adrenalectomy in individuals with obesity. We performed an extensive review of the PubMed, Embase, and Cochrane Library databases for research on adrenalectomy in individuals with obesity up to August 2024. Only studies comparing robot-assisted surgery with laparoscopic surgery were included. Only articles written in English were included. We utilized established criteria for inclusion and exclusion, concentrating on randomized controlled trials and cohort studies. The ROBINS-I instrument was employed to assess the bias risk in non-randomized control studies. Review Manager 5.4.1 was utilized to conduct the meta-analysis. The final analysis incorporated four retrospective cohort studies with a total of 492 individuals with obesity (261 receiving RA and 231 undergoing LA). The results showed that RA was linked to a shorter duration of hospitalization and less estimated blood loss in comparison to LA. Nonetheless, there were no notable distinctions between the two surgical methods in terms of OT, laparotomy conversion rates, overall postoperative complications, or death rates after surgery. In conclusion, RA is a reliable and safe choice for individuals with obesity. It offers notable advantages over LA in terms of LOHS and EBL.

摘要

这项荟萃分析旨在比较肥胖患者中机器人辅助与腹腔镜肾上腺切除术的疗效。我们对 PubMed、Embase 和 Cochrane Library 数据库进行了广泛的检索,以查找截至 2024 年 8 月肥胖患者肾上腺切除术的研究。仅纳入了比较机器人辅助手术与腹腔镜手术的研究。仅纳入了英文撰写的文章。我们使用了既定的纳入和排除标准,重点关注随机对照试验和队列研究。使用 ROBINS-I 工具评估非随机对照研究的偏倚风险。使用 Review Manager 5.4.1 进行荟萃分析。最终分析纳入了四项回顾性队列研究,共 492 名肥胖患者(261 名接受 RA,231 名接受 LA)。结果表明,与 LA 相比,RA 具有住院时间更短和估计出血量更少的优势。然而,两种手术方法在手术时间、剖腹术转换率、总体术后并发症或术后死亡率方面没有显著差异。总之,RA 是肥胖患者的一种可靠且安全的选择。它在 LOHS 和 EBL 方面优于 LA。

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