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单端口与多端口机器人辅助根治性膀胱切除术的围手术期和功能结果:基于对照研究的循证证据。

Perioperative and functional outcomes of single-port versus multi-port robotic-assisted radical cystectomy: evidence-based on controlled studies.

机构信息

Department of Urology, The Second Hospital of Lanzhou University, Lanzhou, 730030, People's Republic of China.

Gansu Province Clinical Research Center for Urology, Lanzhou, China.

出版信息

J Robot Surg. 2024 Sep 23;18(1):344. doi: 10.1007/s11701-024-02094-3.

Abstract

To compare perioperative outcomes of robot-assisted radical cystectomy (RARC) using a single-port (SP) or multi-port (MP) robotic platform. We conducted a comprehensive search of the PubMed, Web of Science, Scopus, and Google Scholar databases until June 2024. For a combined analysis of the data using random effects, Review Manager 5.4 was employed. To compare continuous and categorical variables, the weighted mean difference (WMD) and odds ratio (OR) were employed, respectively. Three original studies were included, comprising a total of 170 patients (SP-RARC: 73 versus MP-RARC: 93).Recovery of bowel function was faster in SP-RARC (WMD -1.02 days, 95% CI - 1.33 to - 0.17; p < 0.001), and lymph-node yield was lower than in MP-RARC patients (WMD - 6.32, 95% CI - 8.90 to - 3.75; p < 0.00001).There were no significant differences between the SP-RARC and MP-RARC groups in terms of other perioperative outcomes such as surgery duration, length of hospital stay, estimated blood loss, major complication rate, positive surgical margin rate, readmission rate, and recurrence rate. The SP robot offers a safe alternative surgical approach to RARC, providing similar postoperative outcomes compared to the MP robot. The SP system remains an attractive option that will require longer follow-up and cohort validation in the future.

摘要

比较使用单端口 (SP) 或多端口 (MP) 机器人平台进行机器人辅助根治性膀胱切除术 (RARC) 的围手术期结果。我们对 PubMed、Web of Science、Scopus 和 Google Scholar 数据库进行了全面检索,检索时间截至 2024 年 6 月。使用随机效应,Review Manager 5.4 对数据进行了综合分析。为了比较连续和分类变量,分别使用加权均数差 (WMD) 和比值比 (OR)。纳入了 3 项原始研究,共纳入 170 例患者(SP-RARC:73 例,MP-RARC:93 例)。SP-RARC 患者的肠道功能恢复更快(WMD -1.02 天,95%CI -1.33 至 -0.17;p<0.001),淋巴结产量低于 MP-RARC 患者(WMD -6.32,95%CI -8.90 至 -3.75;p<0.00001)。在手术时间、住院时间、估计失血量、主要并发症发生率、阳性切缘率、再入院率和复发率等其他围手术期结局方面,SP-RARC 组与 MP-RARC 组之间无显著差异。SP 机器人为 RARC 提供了一种安全的替代手术方法,与 MP 机器人相比,术后结果相似。SP 系统仍然是一个有吸引力的选择,未来需要更长时间的随访和队列验证。

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