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山东大学学报（医学版） ›› 2014, Vol. 52 ›› Issue (7): 60-65.doi: 10.6040/j.issn.1671-7554.0.2013.700

• 临床医学 • 上一篇    下一篇

机器人手术与腹腔镜手术在直肠癌低位前切除术中疗效的Meta分析

徐慧荣1,2, 李健宁3, 李增军1, 徐忠法1   

  1. 1. 山东省肿瘤医院胃肠外科, 山东 济南 250117;
    2. 济南大学医学与生命科学学院, 山东省医学科学院, 山东 济南 250200;
    3. 山东省医科院附属医院麻醉科, 山东 济南 250031
  • 收稿日期:2013-11-22 修回日期:2014-06-12 出版日期:2014-07-10 发布日期:2014-07-10
  • 通讯作者: 徐忠法。E-mail：xzfa2216@126.com E-mail:xzfa2216@126.com
  • 基金资助:
    山东省科技攻关计划（2010g0021859）；山东省自然科学基金 （ZR2010HL024）

Robotic versus laparoscopic low anterior resection：a meta-analysis

XU Huirong1,2, LI Jianning3, LI Zengjun1, XU Zhongfa1   

  1. 1. Department of Gastrointestinal Surgery, Shandong Cancer Hospital, Jinan 250117, Shandong, China;
    2. Medicine and Life Science College, Jinan University, Shandong Academy of Medical Sciences, Jinan 250200, Shandong, China;
    3. Department of Anesthesiology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong, China
  • Received:2013-11-22 Revised:2014-06-12 Online:2014-07-10 Published:2014-07-10

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摘要： 目的 对机器人直肠癌低位前切除术（R-LAR）与传统腹腔镜直肠癌低位前切除术（L-LAR）的短期疗效进行Meta分析。方法 系统检索Medline、Embase、Ovid、中国知网全文数据库（CNKI）、万方数据库，比较R-LAR与L-LAR的所有病例-对照研究，包括发表和未发表的资料和会议论文。由两名作者独立进行方法学质量评价后， 采用RevMan 5.2软件进行Meta分析。结果 共纳入6篇有关的病例-对照研究，合计375例患者。 Meta分析结果表明，机器人低位直肠癌前切除术（R-LAR）组与传统腹腔镜低位直肠癌前切除术（L-LAR）组相比，住院时间缩短（MD=-1.09， 95%CI：-1.95~-0.22， P=0.01），中转开腹率（OR=0.09， 95%CI：0.02~0.47， P=0.005）、总并发症（OR=0.55，95%CI：0.32~0.95， P=0.03）及环周切缘阳性率（OR=0.3， 95%CI：0.11~0.83， P=0.02）均较低，有统计学差异，在手术时间（MD=34.25，95%CI：-5.09~73.58， P=0.09）及淋巴结清扫数目（MD=1，95%CI：-0.67~2.67， P=0.24）方面无统计学差异。结论 在术后短期疗效方面，机器人直肠癌低位前切除术优于传统腹腔镜直肠癌低位前切除术。

关键词: 腹腔镜手术, 直肠癌, Meta分析, 达芬奇机器人手术系统, 低位前切除术

Abstract: Objective To compare the short-term efficacy of robotic low anterior resection (R-LAR) versus laparoscopic low anterior resection (L-LAR) for rectal cancer with meta-analysis. Methods Databases including Medline, Embase, Ovid, CNKI and WANFANG were searched for studies that compared clinical or oncologic outcomes of R-LAP and L-LAP. Relevant published and unpublished data and references were also retrieved. The methodological quality of the incorporated researches was evaluated by two reviewers independently, and RevMan 5.2 software was used for meta-analysis. Results Six studies with 375 patients were included in the analysis. The results showed that R-LAP had longer hospital stay[MD=-1.09, 95%CI(-1.95 to -0.22), P=0.01], lower conversion rate[OR=0.09, 95%CI(0.02 to 0.47), P=0.005], lower circumferential margin involvement positive rate[OR=0.3, 95%CI(0.11 to 0.83), P=0.02], lower overall complication rate[OR=0.55, 95%CI (0.32 to 0.95), P=0.03] compared with L-LAP. There was no difference in operation time[MD=34.25, 95%CI(-5.09 to 73.58), P=0.09] and the number of cleared lymph nodes[MD=1, 95%CI(-0.67 to 2.67), P=0.24]. Conclusion Compared with L-LAR, R-LAR produces more favorable postoperative and oncologic outcomes.

Key words: Da Vinci surgical system, Laparoscopic surgery, Meta-analysis, Rectal cancer, Low anterior resection

中图分类号: 

  • R61
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