系统评价机器人辅助腹腔镜与单纯腹腔镜前列腺癌根治术后的控尿功能

Systematic comparative evaluation of urinary continence after robot-assisted versus pure laparoscopic radical prostatectomy

目的:评价机器人辅助前列腺癌根治术(robot-assisted laparoscopic prostatectomy,RALP)与单纯腹腔镜前列腺癌根治术(pure laparoscopic radical prostatecomy,LRP)的术后控尿功能。方法:检索PubMed、Web of Science、Cochrane图书馆、CNKI、维普数据库及万方数据库关于RALP和LRP治疗局限性前列腺癌的比较性研究文献,按Cochrane操作员手册筛选文献、提取资料并评价质量后,采用RevMan5.2版本软件进行数据处理分析。结果:系统评价纳入2篇随机对照试验,7篇非随机对照试验,共1 950例患者,其中RALP治疗1 098例,LRP治疗852例。RALP相比LRP术后控尿率,1个月比值比(odds ratio,OR)=2.28,95%可信区间(confidence interval,CI)为(1.68,3.08),3个月OR=1.51,95%CI为(1.21,1.88),6个月OR=1.97,95%CI为(1.44,2.70),12个月OR=1.53,95%CI为(1.11,2.11),两者术后控尿功能差异有统计学意义(P<0.05)。结论:在治疗局限性前列腺癌方面,RALP可能术后控尿功能更优。

Objective：To systematically evaluate urinary continence after robot-assisted versus pure laparoscopic radical prostatectomy（LRP）.Method：Databases such as PubMed,Web of Science,Cochrane Library,CNKI,VIP,and Wanfang Data were searched for controlled studies dealing with comparison between robotic-assisted laparoscopic prostatectomy（RALP）and pure LRP for local prostate cancer.We set inclusion and exclusion criteria,extracted data and assessed the methodological quality according to the Cochrane methods handbook.Then,data were analyzed by RevMan 5.2software.Result：Two randomized controlled trials and seven non-randomized controlled trials were included in this analysis.A total of 1 950 patients included 1 098 RALPs and 852 LRPs.Postoperative urinary continence showed significant differences between RALP and LRP at one month,three months,six months and twelve months（P〈0.05）.Conclusion：For the treatment of localized prostate cancer,RALP leads to higher postoperative urinary continence.