机器人辅助胆总管囊肿根治术与传统腹腔镜手术对比的Meta分析  

A meta-analysis of robot-assisted radical choledochal cyst surgery versus traditional laparoscopic surgery

作　　者：马仲福 蔺国瑞 曾永娟 王文赟[1] 李斌德[1] 李刚[1] 赵成基 Ma Zhongfu;Lin Guorui;Zeng Yongjuan;Wang Wenyun;Li Binde;Li Gang;Zhao Chengji(Department of Pediatric Surgery,the Second Hospital of Lanzhou University,Lanzhou 730030,China;Jiuquan Maternal and Child Health Care Hospital,Jiuquan 735000,China)

机构地区：[1]兰州大学第二医院小儿外科,兰州730030 [2]酒泉市妇幼保健院,酒泉735000

出　　处：《中华小儿外科杂志》2025年第2期129-137,共9页Chinese Journal of Pediatric Surgery

摘　　要：目的评价机器人辅助胆总管囊肿根治术与传统腹腔镜手术的优劣,为临床选择不同方法提供循证依据。方法检索中国知网、维普、万方、中国生物医学文献服务系统、PubMed、Embase、the Cochrane Library、Web of Science中英文数据库中有关机器人辅助胆总管囊肿根治术与腹腔镜胆总管囊肿根治术对比的临床研究文献,检索日期自建库至2023年6月。使用Cochrane协作网发布的Cochrane干预性系统综述方法学期望值标准对纳入研究的方法学质量进行评价,以手术效果、术后恢复效果、疼痛评价与患儿经济费用及术后并发症比较作为结局观测指标,使用RevMan Web软件进行Meta分析。结果最终纳入9项研究,包括751例患儿。Meta分析结果显示机器人与腹腔镜在总体手术时间[MD=44.26 min,95%CI(11.41~77.10)]、术中出血量[MD=-9.51 ml,95%CI(-17.78~–1.24)]、囊肿切除时间[MD=–7.47 min,95%CI(-8.95~–5.99)]及肝肠吻合时间[MD=–10.80 min,95%CI(–14.31~–7.29)]等方面的差异均具有统计学意义(P<0.05)。结论机器人辅助胆总管囊肿根治术较传统腹腔镜手术具有囊肿切除时间短、肝肠吻合时间短及术中出血少等手术效果优势,但又有总体手术时间长等缺点。ObjectiveTo evaluate the advantages and disadvantages of robot-assisted radical surgery for choledochal cyst versus traditional laparoscopic surgery,and to provide evidence-based basis for clinical decision making.MethodsArticles reporting robot-assisted radical surgery for choledochal cyst versus traditional laparoscopic surgery were searched in Chinese and English databases,including CNKI,VIP,Wanfang,China Biomedical Literature Service System,PubMed,Embase,the Cochrane Library,and Web of Science.The methodological quality of the included studies was evaluated using the Methodological Expectations of Cochrane Intervention Reviews(MECIR)criteria published by the Cochrane Collaboration.Surgical outcomes,postoperative recovery outcomes,pain evaluation,and comparison of economic costs and postoperative complications were assessed.Meta-analysis was conducted using RevMan Web software.ResultsNine studies representing 751 pediatric patients were ultimately included.The meta-analysis results showed that there were significant differences between robot-assisted radical surgery and traditional laparoscopic surgery in overall surgical time(MD=44.26 min,95%CI:11.41~77.10),intraoperative blood loss(MD=–9.51 ml,95%CI:–17.78~–1.24),cyst resection time(MD=-7.47 min,95%CI:–8.95~–5.99),and hepatointestinal anastomosis time(MD=–10.80 min,95%CI:–14.31~–7.29)(P<0.05).ConclusionsRobot-assisted radical resection of choledochal cyst has advantages over traditional laparoscopic surgery,such as shorter cyst resection time,shorter hepatointestinal anastomosis time,and less intraoperative bleeding.However,it also has disadvantages such as a longer overall surgical time.

关 键 词：胆总管囊肿 达芬奇机器人操作系统 腹腔镜手术 荟萃分析 

分 类 号：R65[医药卫生—外科学]