目的:采用Meta分析的方法比较经腹途径机器人辅助腹腔镜下根治性前列腺切除术(Tp-RALRP)与经腹膜外途径机器人辅助腹腔镜下根治性前列腺切除术(Ep-RALRP)治疗局限性前列腺癌的临床疗效。方法:通过计算机检索Pubmed,EMBASE,Web of scienc...目的:采用Meta分析的方法比较经腹途径机器人辅助腹腔镜下根治性前列腺切除术(Tp-RALRP)与经腹膜外途径机器人辅助腹腔镜下根治性前列腺切除术(Ep-RALRP)治疗局限性前列腺癌的临床疗效。方法:通过计算机检索Pubmed,EMBASE,Web of science,EBSCO,Cochrane library,万方,中国知网(CNKI),中国生物医学数据库(CBM)(2000年1月~2016年11月),入选文献必须对比Tp-RALRP与Ep-RALRP的疗效,包含手术时间、术中出血量、术后留置导尿时间、术后卧床时间、围手术期并发症发生率、切缘阳性率、与肠道有关的并发症发生率、术后尿道吻合口瘘发生率、术后控尿率等指标中的至少一项,运用Meta分析方法比较两种手术方式在治疗局限性前列腺癌疗效上的差异。统计学软件采用Rev Man 5.3软件。结果:经仔细筛选后共有8篇文献纳入该研究,其中Tp-RALRP组451例,Ep-RALRP组676例。与Tp-RALRP相比,Ep-RALRP具有手术时间短(WMD=21.39,95%CI 7.54~35.24,P=0.002),术后卧床时间短(WMD=0.85,95%CI 0.61~1.09,P<0.001)、与肠道有关的并发症发生率低(RR=9.74,95%CI 3.26~29.07,P<0.001)等优势,差异均有统计学意义(P<0.05)。两种手术方式的术中出血量(WMD=-8.12,95%CI-27.86~11.63,P=0.42)、术后留置导尿时间(WMD=-0.17,95%CI-0.55~0.21,P=0.38)、围手术期并发症发生率(RR=1.34,95%CI-0.97~1.87,P=0.08)、切缘阳性率(RR=1.24,95%CI 0.95~1.61,P=0.12)、术后尿道吻合口瘘发生率(RR=0.98,95%CI 0.46~2.10,P=0.95)、术后3个月控尿率(RR=0.96,95%CI 0.91~1.00,P=0.05)及术后6个月控尿率(RR=1.00,95%CI 0.97~1.02,P=0.82)等方面差异均无统计学意义(P>0.05)。结论:与Tp-RALRP相比,Ep-RALRP具有手术时间短、术后卧床时间短、与肠道有关的并发症发生率低等优点,因此,Ep-RLRP可能是治疗局限性前列腺癌更好的方法。但未来仍然需要开展更多多中心、大样本的随机对照研究进而更好地评估两种手术方式的优劣。展开更多
Objective To review published literatures comparing the safety and effectiveness of retroperitoneal laparoscopic partial nephrectomy(RLPN) with transperitoneal laparoscopic partial nephrectomy(TLPN) and provide refere...Objective To review published literatures comparing the safety and effectiveness of retroperitoneal laparoscopic partial nephrectomy(RLPN) with transperitoneal laparoscopic partial nephrectomy(TLPN) and provide reference for clinical work. Methods The search strategy was performed to identify relevant papers from the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Google Scholar, China Hospital Knowledge Database, Wangfang Chinese Periodical Database, and VIP Chinese Periodical Database. All papers comparing RLPN with TLPN were included from 2000 to 2015. Two to three reviewers independently screened, evaluated, and extracted the included papers. A Meta-analysis was executed by using Review Manager 5.3 software. The interesting outcomes were tumor size, operating time, estimated blood loss, warm ischaemia time, length of hospital stay, positive margin rate, open conversion rate, overall complication rate, and recurrence rate. Results The literature search obtained 378 papers, then 10 of them were ultimately met the inclusion criteria and included in the systematic review. Finally, 6 of the 10 papers were included in the Meta-analysis. RLPN had significantly less operating time [P = 0.01, mean difference(MD)=-33.68, 95% confidence interval(CI) within(-60.35,-7.01)] and shorter length of hospital stay [P < 0.0001, MD=-1.47, 95% CI within(-2.18,-0.76)] than TLPN. Significant differences were not found between RLPN and TLPN in other outcomes. Conclusions RLPN may be equally safe and be faster than TLPN. Each center can choose a modality according to your own operating habits and experience.展开更多
The laparoscopic radical prostatectomy （LRP） is a developing technique for treatment of localizedprostate cancer, while the extraperitoneal approach has been highlighted recently.1 From May 2003 to April 2006, we pe...The laparoscopic radical prostatectomy （LRP） is a developing technique for treatment of localizedprostate cancer, while the extraperitoneal approach has been highlighted recently.1 From May 2003 to April 2006, we performed laparoscopic radical prostatectomy by transperitoneal or extraperitoneal approaches in 31 patients with localized prostate cancer. Some parameters of these patients are compared in this article.展开更多
基金Supported by the Science and Technology Plans of Shaoxing Science and Technology Bureau,China(2010D10014)
文摘Objective To review published literatures comparing the safety and effectiveness of retroperitoneal laparoscopic partial nephrectomy(RLPN) with transperitoneal laparoscopic partial nephrectomy(TLPN) and provide reference for clinical work. Methods The search strategy was performed to identify relevant papers from the Cochrane Central Register of Controlled Trials, EMBASE, MEDLINE, Google Scholar, China Hospital Knowledge Database, Wangfang Chinese Periodical Database, and VIP Chinese Periodical Database. All papers comparing RLPN with TLPN were included from 2000 to 2015. Two to three reviewers independently screened, evaluated, and extracted the included papers. A Meta-analysis was executed by using Review Manager 5.3 software. The interesting outcomes were tumor size, operating time, estimated blood loss, warm ischaemia time, length of hospital stay, positive margin rate, open conversion rate, overall complication rate, and recurrence rate. Results The literature search obtained 378 papers, then 10 of them were ultimately met the inclusion criteria and included in the systematic review. Finally, 6 of the 10 papers were included in the Meta-analysis. RLPN had significantly less operating time [P = 0.01, mean difference(MD)=-33.68, 95% confidence interval(CI) within(-60.35,-7.01)] and shorter length of hospital stay [P < 0.0001, MD=-1.47, 95% CI within(-2.18,-0.76)] than TLPN. Significant differences were not found between RLPN and TLPN in other outcomes. Conclusions RLPN may be equally safe and be faster than TLPN. Each center can choose a modality according to your own operating habits and experience.
文摘The laparoscopic radical prostatectomy （LRP） is a developing technique for treatment of localizedprostate cancer, while the extraperitoneal approach has been highlighted recently.1 From May 2003 to April 2006, we performed laparoscopic radical prostatectomy by transperitoneal or extraperitoneal approaches in 31 patients with localized prostate cancer. Some parameters of these patients are compared in this article.
