机器人辅助与传统腹腔镜胆囊切除术治疗良性胆囊疾病疗效比较的Meta分析
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郭天康, Email: TiankangGuo2018@163.com;刘荣, Email: liurong301@126.com

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甘肃省循证医学与临床转化重点实验室基金资助项目(lcxz006);甘肃省兰州市科技局指导性计划基金资助(2017-ZD-38)。


Meta-analysis of robotic-assisted versus conventional laparoscopic cholecystectomy for benign gallbladder diseases
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    摘要:

    目的:比较机器人辅助腹腔镜胆囊切除术(RAC)与传统腹腔镜胆囊切除术(TLC)治疗良性胆囊疾病的疗效。 方法:系统检索文献数据库,按照纳入、排除标准筛选符合标准的文献,用RevMan 5.3软件进行Meta分析。 结果:纳入26篇文献,共4 004例患者,其中1 833例行RAC,2 171例行TLC。Meta分析结果显示,与TLC比较,RAC的手术时间延长(MD=13.14,95% CI=4.79~21.50,P=0.002)、切口疝发生率升高(RR=3.59,95% CI=1.77~7.28,P=0.0004)、术中中转开腹率降低(RR=0.60,95% CI=0.40~0.92,P=0.02)。而在术中并发症、术后并发症、30 d再入院率、住院时间、失血量等方面,两者之间均无统计学差异(均P>0.05)。 结论:当前的证据表明,RAC具有与TLC相似的安全性和有效性但并不比TLC有优势。

    Abstract:

    Objective: To compare the clinical efficacy of robotic-assisted cholecystectomy (RAC) and traditional laparoscopic cholecystectomy (TLC) in treatment of benign gallbladder diseases. Methods: After systematic retrieval in literature databases, the eligible literature of studies was screened out according to the inclusion and exclusion criteria. After data extraction, Meta-analysis was performed by using RevMan 5.3 software. Results: Twenty-six studies were finally included, involving 4 004 patients, of whom, 1 833 cases underwent RAC and 2 171 cases underwent TLC. The results of Meta-analysis showed that RAC had prolonged operative time (MD=13.14, 95% CI=4.79–21.50, P=0.002) and increased incidence of incisional hernia (RR=3.59, 95% CI=1.77–7.28, P=0.0004), but reduced intraoperative conversion rate (RR=0.60, 95% CI=0.40–0.92, P=0.02) compared with TLC. However, no significant differences were found in intraoperative complications, postoperative complications, 30 d readmission rate, length of hospital stay and blood loss between the two procedures (all P>0.05). Conclusion: Current evidence suggests that RAC has similar safety and effectiveness as TLC, but no advantage over TLC.

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韩彩文, 姚亮, 闫沛静, 李美萱, 金大成, 蔡辉, 杨克虎, 刘荣, 郭天康,.机器人辅助与传统腹腔镜胆囊切除术治疗良性胆囊疾病疗效比较的Meta分析[J].中国普通外科杂志,2018,27(8):955-967.
DOI:10.3978/j. issn.1005-6947.2018.08.003

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  • 收稿日期:2018-04-20
  • 最后修改日期:2018-07-20
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  • 在线发布日期: 2018-08-15