Dow Medical College, Dow University of Health Sciences, Karachi, Pakistan.
Shaheed Mohtarma Benazir Bhutto Medical College Lyari, Karachi, Pakistan.
Neurosurg Rev. 2024 Sep 4;47(1):531. doi: 10.1007/s10143-024-02765-7.
Intracerebral hemorrhage (ICH) carries a high mortality rate of around 50% annually, with management traditionally involving medical and surgical approaches. This systematic review and meta-analysis compare robotic neurosurgery with conventional treatments for ICH. We adhered to PRISMA guidelines, analyzing data from MEDLINE, EMBASE, and Cochrane CENTRAL up to October 2023, including randomized controlled trials, non-randomized controlled trials, and cohort studies. We evaluated outcomes such as operation time, drainage time, intraoperative blood loss, hospitalization, mortality, and complications. Of the 10 studies with 1187 participants (609 in robotic neurosurgery and 578 in conventional management), robotic neurosurgery was associated with significantly reduced operation times, drainage times, and hospitalization needs, though intraoperative blood loss and mortality rates showed no significant difference. Robotic neurosurgery also demonstrated a lower risk of rebleeding but similar safety profiles for other complications. Despite these advantages, significant heterogeneity and limited RCTs highlight the need for further research. Robotic neurosurgery appears beneficial in improving ICH management outcomes, warranting additional multicenter trials to confirm long-term efficacy and safety.
脑出血（ICH）的年死亡率约为 50%，传统的治疗方法包括药物和手术。本系统评价和荟萃分析比较了机器人神经外科与ICH 的常规治疗方法。我们遵循 PRISMA 指南，分析了截至 2023 年 10 月 MEDLINE、EMBASE 和 Cochrane CENTRAL 中的数据，包括随机对照试验、非随机对照试验和队列研究。我们评估了手术时间、引流时间、术中出血量、住院时间、死亡率和并发症等结果。在纳入的 10 项研究中（机器人神经外科组 609 例，常规治疗组 578 例），机器人神经外科组的手术时间、引流时间和住院时间显著缩短，但术中出血量和死亡率无显著差异。机器人神经外科组再出血风险较低，但其他并发症的安全性相似。尽管有这些优势，但存在显著的异质性和有限的 RCT，这突出了进一步研究的必要性。机器人神经外科在改善 ICH 管理结果方面似乎有益，需要进一步的多中心试验来确认其长期疗效和安全性。
