达芬奇机器人与腹腔镜手术治疗胃癌的疗效对比：meta分析

发布时间：2018-09-10 19:21

【摘要】：[目的]本研究通过系统分析达芬奇机器人与腹腔镜胃癌手术的临床对比研究来评价达芬奇机器人胃癌手术的近远期疗效与安全性。[方法]通过 PubMed,Medline,Cochrane labrary,Embase,SPRINGER,Elsevier,Web of Science,VIP,数字化期刊全文数据库(万方),相关期刊论文(CNKI),中国生物医学文献数据库(CBM),检索2000年-2017年1月8日机器人与腹腔镜胃癌手术对比的文献。比较两组的手术时间、术中失血量等数据。对获得的数据选用RevMan5.2软件进行处理,依据数据异质性来选取固定效应模型或者随机效应模型进行meta分析。[结果]共纳入17篇文献包含5787人(机器人手术组1676人,腹腔镜手术组4111人)。meta分析结果显示:与传统腹腔镜组相比,机器人组的手术时间更长(WMD=43.51,95%CI[34.14,52.88],P0.05)、术中失血量更少(WMD=-30.17,95%CI[-42.83,-17.51],P0.05)、淋巴结清扫数目更多(WMD=1.95,95%CI[0.07,3.84],P0.05)、首次进食时间更早(WMD=-0.22,95%CI[-0.32,-0.12],P0.05)、患者年龄更小(WMD=-2.24,95%CI[-3.58,-0.89],P0.05)。两组的近端切缘距离、远端切缘距离、R0切除率、术后首次排气时间、术后并发症发生率、术后住院时间、3年生存率、死亡率均无明显差异(P0.05)。[结论]达芬奇机器人胃癌手术安全、有效,且有较好的近远期疗效。
[Abstract]:[objective] to evaluate the efficacy and safety of da Vinci robot gastric cancer surgery by analyzing the clinical comparative study of da Vinci robot and laparoscopic gastric cancer surgery. [methods] the PubMed,Medline,Cochrane labrary,Embase,SPRINGER,Elsevier,Web of Science,VIP, digital full text journal database (Wanfang) and the Chinese journal full-text database (CNKI), Chinese biomedical literature database (CBM), were used to search the literatures of robot and laparoscopic gastric cancer surgery from 2000 to 2017. The operation time and blood loss were compared between the two groups. RevMan5.2 software is used to process the obtained data. According to the heterogeneity of the data, the fixed effect model or random effect model is selected for meta analysis. [results] A total of 17 articles included 5787 people (1676 in the robotic surgery group and 4111 in the laparoscopic group). The results of meta analysis showed that: compared with the traditional laparoscopic group, The robot group had longer operation time (WMD=43.51,95%CI [34.14 卤52.88] P 0.05), less blood loss during operation (WMD=-30.17,95%CI [-42.83 -17.51] P 0.05), more lymph node dissection (WMD=1.95,95%CI [0.07 卤3.84] P 0.05), earlier time of first feeding (WMD=-0.22,95%CI [-0.32 -0.12] P 0.05) and younger age (WMD=-2.24,95%CI [-3.58% -0.89] P 0.05). There was no significant difference between the two groups in the distance between proximal and distal incisal margin and the rate of R0 resection, the first time of exhaust after operation, the incidence of postoperative complications, the postoperative hospitalization time, the 3-year survival rate and the mortality rate (P0.05). Conclusion: da Vinci robot gastric cancer surgery is safe, effective and has good short-and long-term effect.
【学位授予单位】：昆明医科大学
【学位级别】：硕士
【学位授予年份】：2017
【分类号】：R735.2

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