摘要
目的利用meta分析方法比较机器人胰体尾切除术(RDP)与腹腔镜胰体尾切除术(LDP)的近期疗效。方法计算机检索PubMed、The Cochrane Library、EMbase、中国知网、中国生物医学文献数据库及万方数据库,按文献纳入与排除标准筛选出文献并进行质量评估,提取相关数据,应用Revman 5.3软件进行meta分析。结果共计纳入23篇文献,包含3487例行胰体尾切除术的患者。meta分析结果显示,与LDP组相比,RDP组患者的手术时间较长[MD=15.52,95%CI为(0.60,30.45),P=0.04],术中出血量更少[MD=–59.18,95%CI为(–111.62,–6.73),P=0.03],术中保脾率更高[OR=1.74,95%CI为(1.02,2.96),P=0.04],术中中转开腹率更低[OR=0.45,95%CI为(0.34,0.60),P<0.00001],术后住院时间更短[MD=–0.90,95%CI为(–1.70,–0.10),P=0.03],而2组患者的术中输血率[OR=0.88,95%CI为(0.60,1.30),P=0.52]、术后总体并发症发生率[OR=0.88,95%CI为(0.68,1.13),P=0.32]、胰瘘发生率[OR=0.91,95%CI为(0.72,1.14),P=0.41]、90 d再次入院率[OR=1.32,95%CI为(0.95,1.83),P=0.10]和90 d再次手术率[OR=0.73,95%CI为(0.40,1.33),P=0.30]比较差异均无统计学意义。结论RDP具有出血少、术中中转开腹率低及术后住院时间短的优点,但因纳入研究的质量限制,以上结论仍需开展更多高质量的研究予以验证。
Objective To evaluate the short-term effectiveness of robotic distal pancreatectomy(RDP)and laparoscopic distal pancreatectomy(LDP)by meta-analysis.Methods We searched for manuscripts about RDP versus LDP form PubMed,The Cochrane Library,EMbase,CKNI,CBM,and WanFang Databases.The parallel quality assessment was selected according to the literature inclusion and exclusion criteria.Relevant data were extracted and meta-analysis was performed by using Revman 5.3 software.Results A total of 23 articles were included,and a total of 3487 patients enrolled who underwent pancreatic body resection.Meta-analysis results showed that compared with the LDP group,the RDP group had a longer operation time[MD=15.52,95%CI was(0.60,30.45),P=0.04],but the intraoperative blood loss was less[MD=–59.18,95%CI was(–111.62,–6.73),P=0.03],the intraoperative spleen preservation rate was higher[OR=1.74,95%CI was(1.02,2.96),P=0.04],the intraoperative conversion to open rate was lower[OR=0.45,95%CI was(0.34,0.60),P<0.00001],and postoperative hospital stay was shorter[MD=–0.90,95%CI was(–1.70,–0.10),P=0.03],while there were no significant differences in intraoperative blood transfusion rate[OR=0.88,95%CI was(0.60,1.30),P=0.52],incidence of postoperative overall complication[OR=0.88,95%CI was(0.68,1.13),P=0.32]and pancreatic leakage[OR=0.91,95%CI was(0.72,1.14),P=0.41],90-day readmission rate[OR=1.32,95%CI was(0.95,1.83),P=0.10],and 90-day reoperation rate[OR=0.73,95%CI was(0.40,1.33),P=0.30].Conclusions RDP has the advantages of less bleeding,low turnover rate,and short postoperative hospital stay.However,due to the quality limitations of the included studies,the above conclusions still need to be verified by more high-quality studies.
作者
赵欣
雷泽华
高峰畏
蒋康怡
谢青云
乌建平
付金强
杜波
王志旭
ZHAO Xin;LEI Zehua;GAO Fengwei;JIANG Kangyi;XIE Qingyun;WU Jianping;FU Jinqiang;DU Bo;WANG Zhixu(Department of Hepatobilitary and Pancreaticosplenic Surgery,Leshan People’s Hospital of Sichuan Province,Leshan,Sichuan 614000,P.R.China)
出处
《中国普外基础与临床杂志》
CAS
2020年第6期718-728,共11页
Chinese Journal of Bases and Clinics In General Surgery
