机器人与腹腔镜手术系统在骶骨固定术中应用与疗效的Meta分析

Comparison between robotic and laparoscopic sacrocolpopexy on treating pelvic organ prolapse:a meta-analysis

目的:比较机器人骶骨固定术(Robotic sacrocolopexy,RSC)与腹腔镜骶骨固定术(Laparoscopic sacrocolopexy,LSC)的临床疗效。方法:检索2020年3月前万方、维普、中国知网(CNKI)、中国生物医学文献数据库(CBM)、Pubmed、EMbase、Cochrane Library以及Scopus等数据库公开发表的关于RSC和LSC临床疗效比较的研究,采用Cochrane RevMan 5.3软件进行Meta分析。结果:共纳入18篇文献,收集病例2 472例,其中RSC组1 134例,LSC组1 338例。Meta分析结果显示,RSC组手术时间较LSC组长(WMD=37.35,95%CI=24.46~50.24,P<0.00001),术中出血量较LSC组少(WMD=-58.48,95%CI=-100.58~-16.39,P=0.006),腔镜中转率较LSC组低(OR=0.35,95%CI=0.15~0.79,P=0.01),两组在平均住院日、术中并发症、术后并发症、盆腔器官脱垂(Pelvic organ prolapse,POP)治愈率和客观复发的差异无统计学意义(P>0.05)。结论:RSC和LSC均具有高治愈率和低复发的临床疗效,而RSC在手术精细化操作和安全性方面更具有优势,在临床中有较大的应用前景。

Objective:To compare the clinical effects between robotic sacrocolpopexy(RSC)and laparoscopic sacrocolpopexy(LSC)with meta-analysis.Methods:A literature search was performed in WANFANG Data,CQVIP Data,CNKI data,China Biomedical Literature Database(CBM),Pubmed,EMbase,Cochrane Library and Scopus database for clinical researches published on comparison between RSC and LSC before March 2020.Results:18 literatures were included in this study and a total of 2472 cases were collected,including 1134 cases of RSC and 1338 cases of LSC.The results shows that RSC group has longer operation time(WMD=37.35,95%CI=24.46~50.24,P<0.00001),less intraoperative blood loss(WMD=-58.48,95%CI=-100.58~-16.39,P=0.006)and lower conversion rate(OR=0.35,95%CI=0.15~0.79,P=0.01)comparing with LSC group.No significant differences on hospital stay,intraoperative complications,postoperative complications,POP cure rate and objective recurrence between the two groups(P>0.05).Conclusion:RSC has the high cure rate and low recurrence same as LSC,it is superior to LSC in fine operation and surgical safety,which has great application prospects in clinical practice.