PDF下载 ( 2568 KB)
Clinical effect of robotic versus laparoscopic splenectomy in treatment of nontraumatic splenic diseases:A Meta-analysis
-
摘要:
目的比较机器人脾切除术和腹腔镜脾切除术对非创伤性脾脏疾病治疗的有效性和安全性。方法系统检索Pubmed、Web of Science、Embase、Cochrane Library、中国生物医学文献数据库、中国知网数据库、万方数据库和维普数库,根据纳入及排除标准选择比较机器人脾切除术与腹腔镜脾切除术治疗非创伤性脾脏疾病的所有中英文文献,检索时间截止到2019年3月。对纳入文献进行质量学评价后,采用Cochrane library提供的软件RevMan 5. 0进行分析。对研究中的连续性变量及二分类变量分别采用均数差（MD）及率差（RD）为效应指标,计算其合并值及95%可信区间（95%CI）。结果经筛选后共纳入7篇研究,包括374例患者,其中机器人脾切除组160例,腹腔镜脾切除组214例。Meta分析结果显示,与腹腔镜脾切除术相比,机器人脾切除术的术中失血量（MD=-127. 14,95%CI:-199. 87～-54. 42,P<0. 001）、中转开腹率(RD=-0. 06; 95%CI:-0. 11～-0. 01,P=0. 02]及术后并发症(RD=-0. 10,95%CI...
-
关键词:
- 脾切除术 /
- 机器人手术 /
- 腹腔镜检查 /
- Meta分析(主题)
Abstract:Objective To investigate the clinical effect and safety of robotic versus laparoscopic splenectomy in the treatment of nontraumatic splenic diseases. Methods According to the inclusion and exclusion criteria,PubMed,Web of Science,Embase,Cochrane Library,CBM,CNKI,Wanfang Data,and VIP were systematically searched for Chinese and English articles on the comparison of robotic splenectomy and laparoscopic splenectomy in the treatment of nontraumatic splenic diseases published up to March 2019. After quality assessment was performed for the articles included,RevMan 5. 0 provided by Cochrane Library was used for analysis. Mean difference(MD) and rate difference(RD) were used as the effect indicators for continuous variables and binary variables,and pooled value and 95% confidence interval(CI) were calculated. Results A total of 7 studies with 374 patients were included,with 160 patients in the robotic splenectomy group and214 in the laparoscopic splenectomy group. The results of the meta-analysis showed that compared with laparoscopic splenectomy,robotic splenectomy had significantly lower intraoperative blood loss(MD =-127. 14,95% CI:-199. 87 to 54. 42,P < 0. 01),rate of conversion to laparotomy(RD =-0. 06,95% CI:-0. 11 to 0. 01,P = 0. 02),and rate of postoperative complications(RD =-0. 10,95% CI:-0.20 to 0. 01,P = 0. 04). There were no significant differences in time of operation and length of hospital stay between the two surgical procedures(both P > 0. 05). Conclusion Based on current evidence,robotic splenectomy has better clinical effect and safety than laparoscopic splenectomy in some aspects in the treatment of nontraumatic splenic diseases,and more multicenter large-sample randomized controlled trials are needed in the future for verification.
-
Key words:
- splenectomy /
- robotic surgical procedures /
- laparoscopy /
- Meta-analysis as topic
-
[1] DELAITRE B,MAIGNIEN B. Splenectomy by the laparoscopic approach. Report of a case[J]. Presse Med(FRANCE),1991,20(44):2263. [2] CARROLL BJ,PHILLIPS EH,SEMEL CJ,et al. Laparoscopic splenectomy[J]. Surg Endosc,1992,6(4):183-185. [3] HASHIZUME M,SUGIMACHI K,UENO K. Laparoscopic splenectomy with an ultrasonic dissector[J]. N Engl J Med,1992,327(6):438. [4] WINSLOW ER,BRUNT LM. Perioperative outcomes of laparoscopic versus open splenectomy:A meta-analysis with an emphasis on complications[J]. Surgery,2003,134(4):647-653. [5] CORDERA F,LONG KH,NAGORNEY DM,et al. Open versus laparoscopic splenectomy for idiopathic thrombocytopenic purpura:Clinical and economic analysis[J]. Surgery,2003,134(1):45-52. [6] CASACCIA M,TORELLI P,PASA A,et al. Putative predictive parameters for the outcome of laparoscopic splenectomy:A multicenter analysis performed on the Italian Registry of Laparoscopic Surgery of the Spleen[J]. Ann Surg,2010,251(2):287-291. [7] VASILESCU C. Robotic splenectomy—a personal view[J].Chirurgia(Bucur),2010,105(1):83-87. [8] CADIERE GB,HIMPENS J,GERMAY O,et al. Feasibility of robotic laparoscopic surgery:146 cases[J]. World J Surg,2001,25(11):1467-1477. [9] BODNER J,WYKYPIEL H,GREINER A,et al. Early experience with robotassisted surgery for mediastinal masses[J].Ann Thor Surg,2004,78(1):259-265. [10] HANLY EJ,TALAMINI MA. Robotic abdominal surgery[J].Am J Surg,2004,188(4A Suppl):19S-26S. [11] BODNER J,KAFKA-RITSCH R,LUCCIARINI P,et al. A critical comparison of robotic versus conventional laparoscopic splenectomies[J]. World J Surg,2005,29(8):982-985. [12] GELMINI R,FRANZONI C,SPAZIANI A,et al. Laparoscopic splenectomy:Conventional versus robotic approach-a comparative study[J]. J Laparoendosc Adv Surg Tech,2011,21(5):393-398. [13] MOHER D,LIBERATI A,TETZLAFF J. Altman PRISMA Group,Preferred reporting items for systematic reviews and meta-analyses:The PRISMA statement[J]. Int J Surg,2010,8(5):336-341. [14] HOU XW,SHI JP,CHEN X. How to estimate the mean and standard deviation based on the median,range and sample size when conducting meta-analysis[J]. Chin J Evid Based Med,2015,15(2):484-487. [15] HOZO SP,DJUBEGOVIC B,HOZO I. Estimating the mean and variance from the median,range and the size of a simple[J]. BMC Med Res Methodol,2005,5:13. [16] STANG A. Critical evaluation of the Newcastle-Ottawa scale for the assessment of the quality of nonrandomized studies in metaanalyses[J]. Eur J Epidemiol,2010,25(9):603-605. [17] CATALIN V,OANA S,STEFAN T. Laparoscopic versus robotic subtotal splenectomy in hereditaryspherocytosis-Potential advantages and limits of an expensive approach[J]. Surg Endosc,2012,26(10):2802-2809. [18] DAVIDE C,LEONARDO S,DANIELA DP,et al. Robotic vs laparoscopic splenectomy for splenomegaly:A retrospective comparative cohort study[J]. Int J Surg,2018,55:1-4. [19] DANA-ELENA G,STEFAN T,RALUCA PP,et al. Robotic Splenectomy:What is the real benefit?[J]. World J Surg,2014,38(12):3067-3073. [20] MBAKA MI,ROBL E,CAMPS JI. Laparoscopic versus roboticassisted splenectomy in the pediatric population:Our institutional experience[J]. Am Surg,2017,83(9):e358-e359. [21] BERELAVICHUS SV,SMIRNOV AV,IONKIN DA,et al. Robotassisted and laparoscopic partial splenectomy for nonparasitic cysts[J]. Khirurgiia(Mosk),2015,7:41-48. [22] CORDERA F,LONG KH,NAGORNEY DM,et al. Open versus laparoscopic splenectomy for idiopatic thrombocytopenic purpura:Clinical and economic analysis[J]. Surgery,2003,134(1):45-52. [23] ZHAO Y,YU P,HAO Y,et al. Comparison of outcomes for laparoscopically assisted and open radical distal gastrectomy with lymphadenectomy for advanced gastric cancer[J]. Surg Endosc,2011,25(9):2960-2966. [24] SCHULZE SLK,BUGGE K,PERNER A,et al. Cardiovascular and respiratory changes and convalescence in laparoscopic colonic surgery:Comparison between carbon dioxide pneumoperitoneum and gasless laparoscopy[J]. Arch Surg,1999,134(10):1112-1118. [25] RESCORLA FJ,WEST KW,ENGUM SA,et al. Laparoscopic splenic procedures in children:Experience in 231 children[J]. Ann Surg,2007,246(4):683-687. [26] HERY G,BECMEUR F,MEFAT L,et al. Laparoscopic partial splenectomy:Indications and results of a multicenter retrospective study[J]. Surg Endosc,2008,22(1):45-49. [27] VASILESCU C,POPESCU I. Robotic surgery-possibilities and perspectives[J]. Chirurgia(Bucur),2008,103(1):9-11. [28] CORCIONE F,BRACALE U,PIROZZI F,et al. Robotic singleaccess splenectomy using the Da Vinci Single-Siteplatform:A case report[J]. Int J Med Robot,2014,10(1):103-106. [29] LUCANDRI G,FELICIONI F,MONSELLATO I,et al. Robotic splenectomy for mesothelial cyst:A case report[J]. Surg Laparosc Endosc Percutan Tech,2011,21(2):e93-e96. [30] GIULIANOTTI PC,BUCHS NC,ADDEO P,et al. Robot-assisted partial and total splenectomy[J]. Int J Med Robot,2011,7(4):482-488. 期刊类型引用(6)
1. 黄成，崔海坡，谭蔚锋，芦映希，姜赫宣. 肝门阻断夹持器齿型对夹持性能的影响. 生物医学工程学进展. 2022(03): 139-143 . 
百度学术2. 吴均政. 腹腔镜Pringle法联合左肝静脉阻断对左半肝切除术患者术中出血量及凝血指标的影响. 中外医学研究. 2021(26): 45-48 . 百度学术3. 石川，常华，豆松萌，李恒. Pringle联合IVC法在巨大肝血管瘤切除术中的应用效果分析. 河南外科学杂志. 2021(06): 30-33 . 百度学术4. 汪长青，吴珍宝. 不同肝血流阻断对腹腔镜肝切除术患者的影响. 西南国防医药. 2019(02): 116-118 . 百度学术5. 刘雄友，高德山，郭忠涛. 不同肝血流阻断方式对肝切除术安全性及预后的影响. 肝胆外科杂志. 2018(01): 42-46 . 百度学术6. 殷杰，徐新宝，朱日祥. 腹腔镜肝切除术治疗肝血管瘤58例临床分析. 中华肝脏外科手术学电子杂志. 2018(06): 469-472 . 百度学术其他类型引用(2)
-
百度学术
下载:
