机器人辅助腹腔镜与开腹子宫肌瘤切除术比较的Meta分析  

Comparision of robotic surgery with laparotomy for treatment of uterine fibroids:Meta-analysis

作　　者：唐海英[1] 王体春[2] 胡亮[1] 王智彪[1] 陈锦云[1] 

机构地区：[1]重庆医科大学生物医学工程学院省部共建国家重点实验室培育基地-重庆市超声医学工程重点实验室重庆市生物医学工程学重点实验室,重庆400016 [2]重庆医科大学研究生院,重庆400016

出　　处：《中国介入影像与治疗学》2016年第4期248-253,共6页Chinese Journal of Interventional Imaging and Therapy

基　　金：“十二五”国家科技支撑计划项目(2011BAI14B01)

摘　　要：目的通过Meta分析综合比较机器人辅助腹腔镜子宫肌瘤切除术(RALM)与开腹子宫肌瘤切除术(AM)的有效性和安全性。方法检索Embase、PubMed、Web of Science、Cochrane Library Databases、中文科技期刊数据库(VIP)、中国期刊全文数据库(CNKI)、中国生物医学文献数据库(CBM)、万方数字化期刊全文数据库和google学术,检索时限均从建库到2015年6月。由2名研究者按照纳入与排除标准独立筛选文献、提取资料和评价纳入研究的质量后,采用Review Manager 5.3和Stata 11.2进行统计分析并检验发表偏倚。对二分类变量计算其95%可信区间比值比(OR),连续性变量计算其95%可信区间加权均数差(WMD)。结果共纳入10项研究,1 368例研究对象接受了RALM或AM。相比AM,RALM的术中出血量(WMD=-79.51,95%CI-101.98^-57.04,P<0.000 01)、输血量(OR=0.26,95%CI 0.14~0.51,P<0.000 1)、并发症发生率(OR=0.56,95%CI 0.33~0.95,P=0.03)和住院时间(WMD=-1.80,95%CI-2.16^-1.43),P<0.001)显著降低,最大肌瘤直径(WMD=-0.66,95%CI-2.43~1.10,P=0.46)差异无统计学意义,手术时间(WMD=79.60,95%CI 61.81~97.39,P<0.000 01)延长。结论对于治疗子宫肌瘤的患者而言,RALM比AM更安全可靠。Objective To compare the effectiveness and safety between robotic surgery and laparotomy for patients with uterine fibroids by conducting a meta-analysis.Methods Embase,PubMed,Web of Science,Cochrane Library databases,CBM,VIP,CNKI,WANFANG electronic database and google scholar were searched.Retrieval time was the databases built to June 2015.Screening literature,extracting data and quality assessment were applied independently by two reviewers,then statistical analysis and publication bias test was made with Review Manager 5.3and Stata 11.2.Dichotomousvariables were presented by pooled odds ratios with 95% confidence intervals and continuous variables were presented by weighted mean differences with 95% confidence intervals.Results Ten studies were included in the meta-analysis.These studies involved a total of 1 368 patients who underwent both robotic surgery and laparotomy.The rate of complications（OR=0.56,95%CI 0.33—0.95,P=0.03）,length of hospital stay（WMD =-1.80,95%CI-2.16—-1.43,P0.001）,estimated blood loss（WMD=-79.51,95%CI-101.98—-57.04,P0.000 01）,and number of transfusions（OR=0.26,95%CI 0.14— 0.51,P0.000 1）were significantly lower in robotic surgery than in laparotomy,and size of the largest myomas（WMD=-0.66,95% CI-2.43—1.10,P=0.46）were not significantly different between robotic surgery and laparotomy;the operating time（WMD=79.60,95%CI 61.81—97.39,P0.000 01）was significantly longer in robotic surgery than in laparotomy.Conclusion Robotic surgery is normally safer and more reliable than laparotomy for patients with uterine fibroids.

关 键 词：机器人辅助腹腔镜 剖腹术 子宫肿瘤剔除术 

分 类 号：R737.33[医药卫生—肿瘤]