机器人辅助与腹腔镜膀胱癌根治术疗效对比的Meta分析  

Robotic assisted versus laparoscopic radical cystectomy perioperative and oncologic outcomes:A Meta-analysis

作　　者：金培民 肖磊[1] 陈佳[1] 曾铭强 肖伟[1] JIN Peimin;XIAO Lei;CHEN Jia;ZENG Mingqiang;XIAO Wei(The First Affiliated Hospital of Hunan Normal University(Hunan Provincial People's Hospital),Hunan Changsha 410005,China.)

机构地区：[1]湖南师范大学附属第一医院/湖南省人民医院,湖南长沙410005

出　　处：《现代肿瘤医学》2022年第15期2767-2774,共8页Journal of Modern Oncology

基　　金：湖南省自然科学基金项目(编号:2020JJ4401)。

摘　　要：目的:通过Meta分析比较机器人辅助膀胱癌根治术(robotic assisted radical cystectomy,RARC)与腹腔镜膀胱癌根治术(laparoscopic radical cystectomy,LRC)手术效果的差异。方法:通过计算机检索PubMed/MedLine、Web of Science、Embase、Cochrane、中国知网、万方医学网、维普期刊数据库中所有已发表有关RARC和LRC疗效对比的中英文文献。检索时间截止至2020年05月31日。利用RevMan 5.3软件进行Meta分析。结果:最终纳入13篇文献,共有病例数1244例,RARC组690例,LRC组554例。结果显示:与LRC相比,RARC在手术时间(P=0.55)、术后进食时间(P=0.43)、淋巴结阳性检出率(P=0.28)、手术切缘阳性率(P=0.33)、术后复发率(P=0.53)、总体生存率(P=0.43)对比上无统计学差异;而在术中出血量(P=0.002)、输血率(P=0.005)、术后住院时间(P=0.004)、术中淋巴结清扫数目(P=0.0007)、术后并发症发生率(P<0.00001)方面均有统计学差异。结论:与普通腹腔镜相比,机器人手术可减少术中出血量,缩短术后住院时间,并减少并发症。RARC和LRC肿瘤控制结果相似。但由于纳入的研究仅有1项为随机对照研究,结论仍需进一步验证。Objective:The Meta-analysis method is used to compare the differences in perioperative efficacy and oncologic outcomes between robot-assisted(RARC)and laparoscopic radical cystectomy(LRC).Methods:All the published Chinese and English literatures about the efficacy of RARC and LRC in PubMed/MedLine,Web of Science,Embase,Cochrane,CNKI,Wanfang Medical Network and VIP database were searched by computer.The search period ends on May 31,2020.Meta-analysis was carried out by using RevMan 5.3 software.Results:Finally,thirteen articles were included in this Meta-analysis,including 1244 cases in total,with RARC group(n=690)and LRC group(n=554).The results showed that there was no significant difference between RARC and LRC in operation time(P=0.55),postoperative feeding time(P=0.43),positive detection rate of lymph nodes(P=0.28),positive surgical margin(P=0.33),postoperative recurrence rate(P=0.53)and overall survival rate(P=0.43).But there were significant differences between RARC and LRC in intraoperative blood loss(P=0.002),blood transfusion rate(P=0.005),postoperative hospital stay(P=0.004),lymph node yield(P=0.0007)and postoperative complications(P<0.00001).Conclusion:The results show that compared with ordinary laparoscopy,robotic surgery can reduce intraoperative blood loss,shorter postoperative hospital stay,and reduce complications.The tumor control results are similar.However,only one randomized controlled study was included in this Meta-analysis,the conclusion still needs further verification.

关 键 词：膀胱癌 腹腔镜膀胱癌根治术 机器人辅助膀胱癌根治术 META分析 

分 类 号：R737.14[医药卫生—肿瘤]