机器人辅助与传统模式腹腔镜下前列腺根治性切除术的meta分析

发布时间：2018-08-17 19:28

【摘要】：目的·系统评价机器人辅助腹腔镜下前列腺根治性切除术(RALP)和传统腹腔镜下前列腺根治性切除术(LRP)的疗效和术后功能恢复。方法·计算机检索Pub Med、Web of Science、Cochrane图书馆、EMbase、EBSCO、CINAHL、CNKI、万方、维普文献数据库,查找RALP相关的临床对照研究,采用国际Cochrane协作网推荐的Rev Man5.3软件进行系统评价。结果·最终纳入15篇文献,RALP组合计1 621人,LRP组合计1 894人。Meta分析结果显示:在前列腺根治性切除术方面,RALP较LRP能明显减少术中出血量[WMD=-120.29,95%CI(-182.20,-58.39),P=0.000 1]和降低输血率[OR=0.44,95%CI(0.25,0.79),P=0.006],术后第3、6、12个月的控尿率显著提高[OR=2.76,95%CI(1.99,3.82),P0.000 01;OR=2.50,95%CI(1.72,3.63),P0.000 01;OR=2.28,95%CI(1.51,3.46),P0.000 1]。在手术时间、手术切口阳性率、术后并发症方面,RALP和LRP组之间差异无统计学意义(P0.05)。结论·RALP在减少术中出血量和降低输血率方面有明显优势,术后功能恢复较好,远期疗效评价仍需要大规模长时间的随访研究数据。
[Abstract]:Objective to evaluate the efficacy and functional recovery of robotic assisted laparoscopic radical prostatectomy (RALP) and conventional laparoscopic radical prostatectomy (LRP). Methods the Pub MedRALP Web of Science Cochrane Library was searched by computer, and the Rev Man5.3 software recommended by the International Cochrane Cooperation Network was used to evaluate the data base of CINAHLN CNKI, Wanfang and Weipu literature database, and to search for the clinical controlled studies related to RALP. The results were evaluated by the Rev Man5.3 software recommended by the International Cochrane Cooperative Network. Results the results of a meta-analysis of 1 894 patients with 1 621 LRP combinations included in 15 articles showed that RALP could significantly reduce intraoperative blood loss (WMD-120.290.95 CI (-182.20 ~ -58.39) P0.0001] and blood transfusion rate (OR-0.444 / 95CI (0.250.79) P0.006] in radical prostatectomy compared with that of LRP [WMD-120.290.95 CI (-182.20 ~ -58.39) P0.0001], and the results of meta-analysis showed that RALP could significantly reduce the blood loss during operation [WMD-120.290.95 CI (-182.20 ~ -58.39) P0.0001], The urinary control rate increased significantly after 6 months and 12 months [CI (1.99 卤3.82) P0.000 0.01 + 2.50 卤95CI (1.72 卤3.63) CI = 2.28995 CI (1.51 / 3.46) P 0.000 1]. The rate of urinary control was significantly higher than that of control urine in 12 months (P = 2.761, 95 CI, 1.99 卤3.82), P = 2.50 / 95, CI = 2.2895 CI (1.51 / 3.46) (P = 0.000 1). There was no significant difference in operative time, incision positive rate and postoperative complications between LRP group and RALP group (P0.05). Conclusion RALP has obvious advantages in reducing intraoperative blood loss and blood transfusion rate, and the functional recovery is good after operation. The long-term evaluation of long-term curative effect still needs large scale and long term follow-up study data.
【作者单位】：浙江大学医学院附属第一医院病案统计室;
【基金】：浙江省科技计划项目(2013C33122)~~
【分类号】：R737.25

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