机器人与传统腹腔镜右半结肠切除术比较的Meta分析  

Meta-analysis comparing robotic right colectomy with laparoscopic right colectomy on clinical short-term outcomes

作　　者：王位[1,2] 徐慧荣[2] 李增军[2] 孙燕来[2] 徐忠法[2] 

机构地区：[1]济南大学山东省医学科学院医学与生命科学学院,250022 [2]山东省肿瘤医院外四科

出　　处：《中华胃肠外科杂志》2015年第5期463-468,共6页Chinese Journal of Gastrointestinal Surgery

基　　金：山东省自然科学基金（ZR2009CM138）;山东省科技发展计划项目（2013GSF11834）

摘　　要：目的：比较机器人右半结肠切除术（RRC）与传统腹腔镜右半结肠切除术（LRC）的安全性和有效性。方法检索Medline、EMbase、OVID、中国知网（CNKI）以及万方数据库，并手工检索相关文献的参考文献。检索时限均为各数据库建立至2014年7月。采用RevMan 5．2软件进行Meta分析。结果6篇文献的617例患者纳入研究，其中机器人组217例，腹腔镜组400例。Meta分析结果显示，机器人组手术时间长于腹腔镜组（MD＝48．05，95％ CI：26．52～69．57，P＜0．01），术中失血量少于腹腔镜组（MD＝-17．74，95％ CI：-28．32～-7．16，P＝0．01），术后肠蠕动恢复时间较腹腔镜组快（MD＝-0．79，95％ CI：-1．10～-0．48，P＜0．01），术后总并发症发生率低于腹腔镜组（OR＝0．63，95％ CI：0．42～0．93，P＝0．02）。两组中转开腹率和术后住院时间比较，差异均无统计学意义（均P＞0．05）。结论相对于传统腹腔镜，机器人右半结肠切除虽然手术时间有所延长，但术中失血量减少，术后总并发症发生率降低，术后肠功能恢复加快。Objective To compare the clinical short-term safety and efficacy between robotic right colectomy （RRC） and laparoscopic right colectomy （LRC） with meta-analysis. Methods A search of the Medline, Embase, Ovid, CNKI and WANFANG databases was performed for studies comparing clinical or oncologic outcomes of RRC with LRC before July 2014. The RevMan 5.2 software was used for meta-analysis. The operative time, estimated blood loss, length of hospital stay, conversion rate to open surgery, postoperative complications and related outcomes were evaluated. Results Six studies including 217 RRC cases and 400 conventional LRC cases were enrolled and analyzed. The meta-analysis showed that RRC had longer operative time （MD=48.05,95%CI：26 . 52 to 69 . 57 , P〈0 . 01 ） , less estimated blood loss （ MD=-17 . 74 , 95% CI： -28 . 32 to -7 . 16 , P=0.01）, faster postoperative intestinal peristalsis recovery （MD=-0.79, 95% CI：-1.10 to -0.48, P〈0.01）, lower postoperative overall complications （OR=0.63, 95% CI： 0.42 to 0.93, P=0.02）. Conversion rate and postoperative hospital stay between the two groups were not significantly different（all P〉0.05）. Conclusion Compared to LRC, RRC is associated with less estimated blood loss, faster postoperative intestinal peristalsis recovery , lower postoperative overall complications , and longer operative time.

关 键 词：达芬奇机器人手术系统 腹腔镜手术 右半结肠切除术 META分析 

分 类 号：R656[医药卫生—外科学]