中华消化外科杂志
中華消化外科雜誌
중화소화외과잡지
CHINESE JOURNAL OF DIGESTIVE SURGERY
2013年
7期
500-503
,共4页
王家胜%李中福%杨强%杨林
王傢勝%李中福%楊彊%楊林
왕가성%리중복%양강%양림
结直肠肿瘤%达芬奇机器人手术系统%腹腔镜检查%切除术%Meta分析
結直腸腫瘤%達芬奇機器人手術繫統%腹腔鏡檢查%切除術%Meta分析
결직장종류%체분기궤기인수술계통%복강경검사%절제술%Meta분석
Colorectal neoplasms%da Vinci robotic surgical system%Laparoscopy%Resection%Meta analysis
目的 比较达芬奇机器人手术系统与传统腹腔镜治疗结直肠癌的疗效.方法 检索PubMed、Cochrane Library、EMBASE、Medline、万方、知网、维普、康健等数据库,并检索纳入文献的参考文献.检索时间从建库至2012年2月.收集达芬奇机器人手术系统与传统腹腔镜治疗结直肠癌的随机对照试验(RCT)和非随机对照试验(NRCT).按预设标准进行筛选并进行质量评价,将纳入文献的患者分为机器人组和传统腹腔镜组,提取数据后用RevMan5.1软件进行Meta分析,比较两种手术方式治疗结直肠癌的疗效.二分类变量采用优势比(OR)及95％可信区间(95％ CI)表示,连续性变量采用加权均数差(WMD)及95％ CI表示.结果 共纳入1个RCT及10个NRCT,共计结直肠癌患者974例,其中机器人组426例,传统腹腔镜组548例.Meta分析结果显示:与传统腹腔镜组比较,机器人组手术时间长、中转开腹率低、术后肛门排气时间短(WMD =25.61,OR =0.32,WMD =-0.21,P ＜0.05)；两组患者术中出血量、淋巴结检出数目、远切缘距肿瘤距离、并发症发生率及住院时间比较,差异无统计学意义(WMD=-23.14,-0.31,0.14,OR=1.06,WMD =-0.43,P ＞0.05).结论 达芬奇机器人手术系统与传统腹腔镜治疗结直肠癌的肿瘤切除情况无差异,但达芬奇机器人手术系统结直肠癌切除术具有中转开腹率较低、术后肛门排气时间较短等优势.
目的 比較達芬奇機器人手術繫統與傳統腹腔鏡治療結直腸癌的療效.方法 檢索PubMed、Cochrane Library、EMBASE、Medline、萬方、知網、維普、康健等數據庫,併檢索納入文獻的參攷文獻.檢索時間從建庫至2012年2月.收集達芬奇機器人手術繫統與傳統腹腔鏡治療結直腸癌的隨機對照試驗(RCT)和非隨機對照試驗(NRCT).按預設標準進行篩選併進行質量評價,將納入文獻的患者分為機器人組和傳統腹腔鏡組,提取數據後用RevMan5.1軟件進行Meta分析,比較兩種手術方式治療結直腸癌的療效.二分類變量採用優勢比(OR)及95％可信區間(95％ CI)錶示,連續性變量採用加權均數差(WMD)及95％ CI錶示.結果 共納入1箇RCT及10箇NRCT,共計結直腸癌患者974例,其中機器人組426例,傳統腹腔鏡組548例.Meta分析結果顯示:與傳統腹腔鏡組比較,機器人組手術時間長、中轉開腹率低、術後肛門排氣時間短(WMD =25.61,OR =0.32,WMD =-0.21,P ＜0.05)；兩組患者術中齣血量、淋巴結檢齣數目、遠切緣距腫瘤距離、併髮癥髮生率及住院時間比較,差異無統計學意義(WMD=-23.14,-0.31,0.14,OR=1.06,WMD =-0.43,P ＞0.05).結論 達芬奇機器人手術繫統與傳統腹腔鏡治療結直腸癌的腫瘤切除情況無差異,但達芬奇機器人手術繫統結直腸癌切除術具有中轉開腹率較低、術後肛門排氣時間較短等優勢.
목적 비교체분기궤기인수술계통여전통복강경치료결직장암적료효.방법 검색PubMed、Cochrane Library、EMBASE、Medline、만방、지망、유보、강건등수거고,병검색납입문헌적삼고문헌.검색시간종건고지2012년2월.수집체분기궤기인수술계통여전통복강경치료결직장암적수궤대조시험(RCT)화비수궤대조시험(NRCT).안예설표준진행사선병진행질량평개,장납입문헌적환자분위궤기인조화전통복강경조,제취수거후용RevMan5.1연건진행Meta분석,비교량충수술방식치료결직장암적료효.이분류변량채용우세비(OR)급95％가신구간(95％ CI)표시,련속성변량채용가권균수차(WMD)급95％ CI표시.결과 공납입1개RCT급10개NRCT,공계결직장암환자974례,기중궤기인조426례,전통복강경조548례.Meta분석결과현시:여전통복강경조비교,궤기인조수술시간장、중전개복솔저、술후항문배기시간단(WMD =25.61,OR =0.32,WMD =-0.21,P ＜0.05)；량조환자술중출혈량、림파결검출수목、원절연거종류거리、병발증발생솔급주원시간비교,차이무통계학의의(WMD=-23.14,-0.31,0.14,OR=1.06,WMD =-0.43,P ＞0.05).결론 체분기궤기인수술계통여전통복강경치료결직장암적종류절제정황무차이,단체분기궤기인수술계통결직장암절제술구유중전개복솔교저、술후항문배기시간교단등우세.
Objective To compare the efficacies of da Vinci robotic and traditional laparoscopic resection for colorectal cancer.Methods Databases including Pubmed,Cochrane Library,EMBASE,Medline,Wanfang,CNKI,VIP and FMJS were searched,and literatures published before February 2012 were retrieved.Randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) focusing the comparison between da Vinci robotic and laparoscopic resection for colorectal cancer were collected.All the literatures retrieved were screened according to preset standards,and the patients were divided into robotic group and laparoscopic group.A meta analysis on the effectiveness of robotic and laparoscopic surgery for colorectal cancer was carried out using the RevMan 5.1 software.Categorical variables were presented by odds ratio (OR) and 95％ confidence interval (95 ％ CI),continuous variables were presented by weighted mean difference (WMD) and 95 ％ CI.Results One RCT and 10 NRCTs including 974 patients with colorectal cancer were screened out and there were 426 patients in the robotic group and 548 patients in the laparoscopic group.Compared with conventional laparoscopic surgery,longer operation time,lower rate of conversion to laparotomy and shorter anal exsufflation time were observed in the robotic group (WMD =25.61,OR =0.32,WMD =-0.21,P ＜ 0.05).There were no significant differences in the operative blood loss,number of lymph node dissected,distal resection margin,morbidity and duration of hospital stay between the robotic group and the laparoscopic group (WMD =-23.14,-0.31,0.14,OR =1.06,WMD =-0.43,P ＞ 0.05).Conclusion The efficacies of da Vinci robotic and laparoscopic surgery for the treatment of colorectal cancer are comparable,while da Vinci robotic surgery has the features of lower rate of conversion to laparotomy and shorter anal exsufflation time.
