机器人手术与开放手术治疗肝门部胆管癌疗效与安全性的荟萃分析  

A meta-analysis of the efficacy and safety of robotic surgery versus open surgery in the treatment of hilar cholangiocarcinoma

作　　者：胡满琴 许丁伟 张燕[1] 李翱 李新成[1] 黄洁[1] Hu Manqin;Xu Dingwei;Zhang Yan;Li Ao;Li Xincheng;Huang Jie(Department of Hepatobiliary and Pancreatic SurgeryⅢ,the Second Affiliated Hospital of Kunming Medical University,Kunming 650101,China)

机构地区：[1]昆明医科大学第二附属医院肝胆胰外科三病区,昆明650101

出　　处：《中华肝胆外科杂志》2024年第1期62-66,共5页Chinese Journal of Hepatobiliary Surgery

基　　金：云南省科技厅基础研究专项基金(202101AT070239)。

摘　　要：目的:比较机器人手术与开放手术治疗肝门部胆管癌的疗效及安全性。方法:计算机检索PubMed、Embase、Cochrane Library、Web of Science、中国知网和万方数据库建库至2023年7月比较机器人手术与开放手术治疗肝门部胆管癌的病例对照研究。主要观察指标为手术时间、术中输血率、R 0切除率、淋巴结转移率、术后并发症发生率、住院时间。采用RevMan 5.4软件处理数据,计算合并的优势比( OR)及均数差( MD)和95%可信区间(95% CI)。 结果:共纳入4篇研究,共267例肝门部胆管癌患者,其中男性177例,女性90例,年龄(58.8±5.7)岁。267例患者依据不同手术方式,165例纳入开放手术组,102例纳入机器人手术组。荟萃分析结果显示:机器人手术组与开放手术组患者手术时间( MD=-103.96,95% CI:-216.90~8.98, P=0.070)、术中输血率( OR=1.32,95% CI:0.43~4.07, P=0.630)、R 0切除率( OR=1.41,95% CI:0.71~2.81, P=0.330)、淋巴结转移率( OR=1.62,95% CI:0.46~5.63, P=0.450)、术后并发症发生率( OR=0.60,95% CI:0.28~1.31, P=0.200)、住院时间( MD=2.17,95% CI: -11.56~15.90, P=0.760)比较,差异均无统计学意义。 结论:在肝门部胆管癌的治疗中,机器人手术与开放手术一样安全可行,但受纳入研究数量和质量限制,上述结论尚待更多高质量研究予以验证。Objective To compare the efficacy and safety of robotic surgery and open surgery in the treatment of hilar cholangiocarcinoma.MethodsPubMed,Embase,Cochrane Library,Web of Science,CNKI and Wanfang database were searched to compare the treatment of hilar cholangiocarcinoma by robotic surgery and traditional open surgery.Literatures were searched from the establishment of the database to July 2023.Compare operation time,intraoperative blood transfusion rate,R 0 resection rate,lymph node metastasis rate,postoperative complication rate and hospital stays between the two groups.The combined odds ratio(OR)and mean difference(MD)and 95%confidence interval(95%CI)were calculated using RevMan 5.4 software.ResultsA total of 4 studies were included,including 267 patients with hilar cholangiocarcinoma.There were 177 males and 90 females,aged(58.8±5.7)years.A total of 267 patients were divided into open surgery group(n=165)and robotic surgery group(n=102)according to the surgical formula.The extract results show:operative time(MD=-103.96,95%CI:-216.90-8.98,P=0.070)and intraoperative blood transfusion rate(OR=1.32,95%CI:0.43-4.07,P=0.630),R 0 resection rate(OR=1.41,95%CI:0.71-2.81,P=0.330),lymph node metastasis rate(OR=1.62,95%CI:0.46-5.63,P=0.450),postoperative complications(OR=0.60,95%CI:0.28-1.31,P=0.200),and postoperative hospital stay(MD=2.17,95%CI:-11.56-15.90,P=0.760).ConclusionIn the treatment of hilar cholangiocarcinoma,robotic surgery is as safe and feasible as open surgery.However,due to the limited number and quality of included studies,the above conclusions need to be verified by more high-quality studies.

关 键 词：机器人手术 Klatskin肿瘤 META分析 开放手术 

分 类 号：R735.8[医药卫生—肿瘤]