达芬奇机器人与腹腔镜手术治疗胃癌疗效比较的Meta分析

发布时间：2019-07-21 15:05

【摘要】：目的:系统评价达芬奇机器人胃癌手术的有效性、安全性与近远期疗效。方法:检索国内外数据库,收集比较达芬奇机器人胃癌手术与传统腹腔镜胃癌手术的文献,对获得的数据用Rev Man5.2软件进行Meta分析。结果:纳入17篇文献,共5787例患者,其中机器人手术1676例,传统腹腔镜手术4111例。Meta分析结果显示,与传统腹腔镜手术比较,机器人手术所用时间延长(WMD=43.51,95%CI=34.14~52.88,P0.05)、术中失血量减少(WMD=-30.17,95%CI=-42.83~-17.51,P0.05)、淋巴结清扫数目增加(WMD=1.95,95%CI=0.07~3.84,P0.05)、首次进食时间提前(WMD=-0.22,95%CI=-0.32~-0.12,P0.05),而其他指标包括近远端切缘距离、R0切除率、中转率、术后首次排气时间、术后住院时间、并发症发生率、病死率、3年生存率均相似(均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 systematically evaluate the effectiveness, safety and short-term and long-term efficacy of Leonardo da Vinci robot gastric cancer surgery. Methods: the domestic and foreign databases were searched, the literature of Leonardo da Vinci robot gastric cancer surgery and traditional laparoscopic gastric cancer surgery were collected and compared, and the obtained data were analyzed by Meta with Rev Man5.2 software. Results: a total of 5787 patients were included in 17 articles, including 1676 cases of robot surgery and 4111 cases of traditional laparoscopic surgery. Meta-analysis showed that compared with traditional laparoscopic surgery, robot surgery took longer time (WMD=43.51,95%CI=34.14~52.88,P0.05), decreased intraoperative blood loss (WMD=-30.17,95%CI=-42.83~-17.51,P0.05) and increased the number of lymph node dissection (WMD=1.95,95%CI=0.07~3.84,). (P 0.05), the first eating time was advanced (WMD=-0.22,95%CI=-0.32~-0.12,P0.05), while other indexes included proximal and distal margin distance, R0 resection rate, conversion rate, postoperative first exhaust time, postoperative hospitalization time, incidence of complications, mortality, 3-year survival rate were similar (all P 0.05). Conclusion: Leonardo da Vinci robot gastric cancer surgery is safe, effective and has a good short-term and long-term effect.
【作者单位】：昆明医科大学第一附属医院胃肠外科;云南省消化病研究所;
【基金】：云南省科技计划资助项目(2014FB021) 云南省卫生科技计划资助项目(2014NS124;2016NS003)
【分类号】：R735.2

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