经腹途径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临床疗效的Meta分析
发布时间：2018-08-20 11:15
【摘要】：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,P0.001)、与肠道有关的并发症发生率低(RR=9.74,95%CI 3.26~29.07,P0.001)等优势,差异均有统计学意义(P0.05)。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(P0.05)。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。
[Abstract]:Objective: to compare the clinical efficacy of robot-assisted laparoscopic prostatectomy (Tp-RALRP) and retroperitoneal robotic-assisted laparoscopic prostatectomy (Ep-RALRP) in the treatment of localized prostate cancer by Meta analysis. Methods: we searched Pubmedus EMBASEN web of science (CNKI), Cochrane library, Wanfang, and (CNKI), Chinese biomedical database (CBM) (from January 2000 to November 2016. We must compare the efficacy of Tp-RALRP and Ep-RALRP, including operation time, intraoperative bleeding volume, postoperative indwelling time and indwelling catheterization time, among the selected documents, we should compare the efficacy of Tp-RALRP and Ep-RALRP, including the time of operation, the amount of blood lost during operation, and the time of indwelling catheterization after operation. At least one of the indexes included postoperative bed-rest time, perioperative complications, positive incisal margin, intestinal complications, postoperative urethral anastomotic fistula, postoperative urinary control rate, and so on. Meta analysis was used to compare the efficacy of the two surgical methods in the treatment of localized prostate cancer. The statistical software was Rev Man 5.3. Results: after careful screening, a total of 8 articles were included in the study, including 451 cases in Tp-RALRP group and 676 cases in Ep-RALRP group. Compared with Tp-RALRP, Ep-RALRP had the advantages of shorter operation time (WMD-21.39 / 95CI 7.5435. 24m P0.002), shorter bed-rest time (WMD-0.8595 CI 0.61CI-1.09p0.001) and lower incidence of intestinal complications (RRR9.795CI 3.262.077P0.001). The difference was statistically significant (P0.05). 涓ょ鎵嬫湳鏂瑰紡鐨勬湳涓嚭琛，
本文编号：2193382
[Abstract]:Objective: to compare the clinical efficacy of robot-assisted laparoscopic prostatectomy (Tp-RALRP) and retroperitoneal robotic-assisted laparoscopic prostatectomy (Ep-RALRP) in the treatment of localized prostate cancer by Meta analysis. Methods: we searched Pubmedus EMBASEN web of science (CNKI), Cochrane library, Wanfang, and (CNKI), Chinese biomedical database (CBM) (from January 2000 to November 2016. We must compare the efficacy of Tp-RALRP and Ep-RALRP, including operation time, intraoperative bleeding volume, postoperative indwelling time and indwelling catheterization time, among the selected documents, we should compare the efficacy of Tp-RALRP and Ep-RALRP, including the time of operation, the amount of blood lost during operation, and the time of indwelling catheterization after operation. At least one of the indexes included postoperative bed-rest time, perioperative complications, positive incisal margin, intestinal complications, postoperative urethral anastomotic fistula, postoperative urinary control rate, and so on. Meta analysis was used to compare the efficacy of the two surgical methods in the treatment of localized prostate cancer. The statistical software was Rev Man 5.3. Results: after careful screening, a total of 8 articles were included in the study, including 451 cases in Tp-RALRP group and 676 cases in Ep-RALRP group. Compared with Tp-RALRP, Ep-RALRP had the advantages of shorter operation time (WMD-21.39 / 95CI 7.5435. 24m P0.002), shorter bed-rest time (WMD-0.8595 CI 0.61CI-1.09p0.001) and lower incidence of intestinal complications (RRR9.795CI 3.262.077P0.001). The difference was statistically significant (P0.05). 涓ょ鎵嬫湳鏂瑰紡鐨勬湳涓嚭琛，
本文编号：2193382
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