摘要
目的对比机器人与传统腹腔镜行胰体尾切除术在近期临床疗效上的优劣。方法系统检索PubMed、Embase、Cochrane library、万方数据库、中国知网,收集对比机器人组与传统腹腔镜组胰体尾切除术近期临床疗效的文献。观察指标包括手术时间、术中输血率、保脾率、保脾血管率、中转开腹率、术后并发症发生率、术后严重并发症发生率、胰漏率、严重胰漏率、住院时间等。采用RevMan5.3软件进行Meta分析。结果共纳入11篇非随机对照研究,共计791例患者。Meta分析结果表明,机器人组相比于传统腹腔镜组保脾率高,差异具有统计学意义(OR=2.32,95%CI:1.07~5.04,P=0.03);保脾血管率高,差异具有统计学意义(OR=3.07,95%CI:1.10~8.57,P=0.03);中转开腹率低,差异具有统计学意义(OR=0.58,95%CI:0.35~0.97,P=0.04);住院时间短,差异具有统计学意义(MD=-2.42,95%CI:-4.30^-0.55,P=0.01);手术时间长,差异具有统计学意义(MD=27.11,95%CI:9.06~45.16,P<0.01)。但术后并发症发生率、术后严重并发症发生率、胰漏率、严重胰漏率及术中输血率等结局指标差异无统计学意义。结论机器人胰体尾切除术在近期疗效上显现了一定程度上的优势,值得在有条件的大型医疗中心推广,关于2种术式在远期疗效上的比较还需要进一步的随访研究。
Objective To compare the short-term clinical outcomes of robotic distal pancreatectomy(RDP)with laparoscopic distal pancreatectomy(LDP).Methods PubMed,Embase,Cochrane library,Wanfang data,CNKI were searched systematically.Studies that compared short-term clinic outcomes between RDP and LDP groups were included.Observation indicators include:operation time,intraoperative blood transfusion rate,spleen preserving rate,spleen vessels preserving rate,conversion rate to open surgery,complication rate,severe complication rate,pancreatic fistula rate,severe pancreatic fistula rate,length of hospital stay,etc.The Meta-analysis was performed by using RevMan5.3.Results Eleven non-randomized controlled trials with 791 patients meet the inclusion criteria.This Meta-analysis shows:compared with LDP group,RDP group was associated with higher spleen preserving rate(OR=2.32,95%CI:1.07-5.04,P=0.03),higher splenic vessels preserving rate(OR=3.07,95%CI:1.10-8.57,P=0.03),lower conversion rate to open surgery(OR=0.58,95%CI:0.35-0.97,P=0.04),shorter hospital stay(MD=-2.42,95%CI:-4.30--0.55,P=0.01),longer operative time(MD=27.11,95%CI:9.06-45.16,P<0.01).There was no significant difference in overall complications,severe complications,pancreatic fistula,severe pancreatic fistula,and transfusion rate between the two groups.Conclusions RDP showed a slight advantage in short-term outcomes,and it is worthy of applying in large medical center.Further studies on the long-term outcomes of these surgical techniques are required.
作者
杨易戎
刘宏
熊建霞
郭昊苏
李凯
Yang Yirong;Liu Hong;Xiong Jianxia;Guo Haosu;Li Kai(Department of General Surgery,First Hospital of Shanxi Medical University,Taiyuan 030001,China)
出处
《国际外科学杂志》
2020年第5期302-307,I0005,共7页
International Journal of Surgery
