机器人系统及腹腔镜辅助行胃癌根治术治疗胃癌近期疗效对比Meta分析

Comparison of short-term clinical outcomes between robotic and laparoscopic gastrectomy for gastric cancer:A Meta analysis

目的评价达芬奇机器人手术治疗胃癌的安全性、有效性和近期疗效。方法计算机检索多个国内外数据库,收集2009年1月至2014年4月公开发表的有关机器人胃切除术(robot gastrectomy,RG)和腹腔镜胃切除术(laparoscopy gastrectomy,LG)对比的英文文献,按纳入和排除标准筛选文献、提取资料和质量评价后,利用Review Manager 5.2统计软件行Meta分析。结果共有11篇文献3503例病人纳入本次分析,其中RG手术993例,LG手术2510例。Meta分析结果显示,与LG组比较,RG组手术时间更长,但术中出血量更少、术后首次进食更早和远端切缘距离更远,而术后排气时间、术后住院时间、术后并发症发生率、近端切缘距离、术后淋巴结检出数目等方面差异无统计学意义(P>0.05)。结论 RG治疗胃癌安全、可靠,具有较好的近期疗效。

Objective To compare robotic gastrectomy （RG） with laparoscopic gastrectomy （LG） in the treatment of gastric cancer by performing a systematic review and Meta-analysis of all published literature. Methods The literatures comparing RG with LG published between January 2009 and April 2014 in the major domestic and foreign databases were retrieved and analyzed systematically. After screening for inclusion,data extraction and quality assessment,Meta-analysis was conducted by the Review Manager 5.2 software. Results There were eleven studies meeting the inclusion criteria for Meta—analysis.The total sample size of the studies was 3503 cases. Among them, 993 cases underwent RG and 2510 cases were subjected to LG.Compared to LG,RG experienced longer operative time,but experienced less intraoperative blood loss,shorter time of oral intake and longer distal resection margin. The time of postoperative flatus,postoperative hospital stay,postoperative complications,proximal resection margin and retrieved lymph nodes were similar between the two groups（P〉0.05）. Conclusion RG is a safe and feasible procedure and has a good short-term effect.