摘要
目的系统评价达芬奇机器人手术系统与腹腔镜胃癌根治术的近期疗效。方法以gastric cancer,gastrectomy ,da Vinci surgical system,laparoscopic ,laparoscopy,胃癌、胃切除术、达芬奇机器人手术系统、腹腔镜为检索词，检索PubMed、EMBASE、Cochrane Library、Medline、中国期刊全文数据库、万方数据库、维普数据库及中国生物医学期刊文献数据库。检索时间为2002年5月至2014年3月。纳入研究达芬奇机器人手术系统与腹腔镜胃癌根治术的临床疗效的相关对照试验，由2名研究者独立筛选文献和提取数据，并进行文献质量评价。行达芬奇机器人手术系统胃癌根治术患者为机器人组，行腹腔镜胃癌根治术患者为腹腔镜组。应用RevMan 5．2统计软件进行Meta分析。计数资料采用相对危险度（RR）及95％可信区间（95％CI）表示，计量资料采用加权均数差（WMD）及95％CI表示。采用，对异质性进行分析。结果最终纳入符合标准的相关研究共11篇，累计样本量3698例，其中机器人组953例，腹腔镜组2745例。Meta分析结果显示：与腹腔镜组比较，机器人组胃癌患者手术时间显著延长，术中出血量显著减少，术后肛门排气时间、术后经口进食时间及术后住院时间显著缩短，差异有统计学意义（WMD=51．23，-36．96，-0．24，-0．26，-1．11，95％CI：28．01～74．46，-61．28～-12．65，-0．42～-0．06，-0．39～-0．14，-1．92～-0．29，P〈0．05）；淋巴结检出数目，远、近切缘距肿瘤距离及术后并发症发生率两组比较，差异无统计学意义（WMD=1．63，0．21，0．06，RR：1．11，95％CI：-0．49～3．76，-0．65—1．06，-0．13～0．25，0．90～1．37，P〉0．05）。结论达芬奇机器人手术系统与腹腔镜胃癌根治术同样安全可行，且前者手术创伤更小，术后恢复更快，患者能在近期疗效上获益。
Objective To compare the short-term efficacy between da Vinci robotic and laparoscopie radical gastreetomy for gastric cancer. Methods Database including PubMed, EMBASE, the Coehrane Library, Medline, the China National Knowledge Infrastructure （CNKI）, Wanfang Database, VIP and China Biomedicine were searched with the key words of gastric cancer, gastreetomy, da Vinci surgical system, laparoscopic, laparoscopy,胃癌、胃切除术、达芬奇机器人手术系统 and 腹腔镜.Literatures published between May 2002 and March 2014 were retrieved. Related controlled trials containing the clinical efficacy of da Vinci robotic and laparo- scopie radical gastrectomy for gastric cancer were enrolled in the study, and then the literatures were screened and the data were extracted by 2 independent reviewers. The quality of the literatures was assessed, and the data were analyzed using the RevMan 5.2 software. Patients receiving da Vinci robotic surgery and laparoscopie surgery were allocated into the robotic group and laparoscopy group, respectively. The count data were analyzed using the relative risk （RR） and 95% confidence interval （95% CI）, and the measurement data were analyzed using weighted mean difference （ WMD ） and 95 % CI. The heterogeneity of the data was analyzed using the 12 test. Results Eleven literatures including 3 698 cases were enrolled in the study. There were 953 patients in the robotic group and 2 745 patients in the laparoscopic group. There were significant differences in the operation time, volume of intraoperative blood loss, time of postoperative flatus, time of first oral intake and duration of postoperative hospital stay between the 2 groups （ WMD = 51.23, - 36. 96, - 0. 24, - 0. 26, - 1.11,95 % CI： 28.01-74.46, -61.28- - 12. 65, - 0. 42- - 0. 06, - 0. 39- - 0. 14, - 1.92- - 0. 29, P 〈 0.05 ）. There was no significant difference in the number of lymph nodes resected, the distance to proximal and distal resection margin and overall incidence of postoperative complica
出处
《中华消化外科杂志》
CAS
CSCD
北大核心
2015年第3期200-206,共7页
Chinese Journal of Digestive Surgery
基金
重庆市科技攻关项目（CSTC2012ggyyjs10029）
