临床研究(Clinical Research)

机器人与腹腔镜手术治疗胃癌的近期疗效对比Meta 分析

Published at: 2015年第24卷第4期

吉国锋 1 , 陶有茂 1 , 张涛 1 , 王刚 1 , 李俊成 1 , 戚少龙 1 , 马冲 1
1 吉林大学中日联谊医院新民院区 胃肠外科,吉林 长春 130021
通讯作者 冲 马 Email: machong1966@163.com
DOI: 10.3978/j.issn.1005-6947.10.3978/j.issn.1005-6947.2015.04.015
基金:

摘要

目的:系统评价机器人胃切除术(RG)治疗胃癌的安全性、有效性和近期疗效。 方法:检索国内外数据库,收集2005 年1 月—2015 年1 月间发表的对比RG 和腹腔镜胃切除术(LG) 治疗胃癌近期疗效的中文和英文文献,使用RevMan 5.3 软件进行Meta 分析。 结果:最终纳入15 篇文献,共计5 286 例胃癌患者,其中RG 组1 618 例,LG 组3 668 例。Meta 分 析结果显示,与LG 组比较,RG 组术中出血量明显减少(WMD=-38.79,95% CI=-53.73~-23.84), 淋巴结清扫数目多(WMD=2.13,95% CI=1.45~2.80),胃肠功能恢复时间、进食时间和术后住院时 间缩短(WMD=-0.27,95% CI=-0.37~-0.16;WMD=-0.25,95% CI=-0.37~-0.14;WMD=-0.82, 95% CI=-1.32~-0.32),但手术时间明显延长(WMD=37.39,95% CI=26.79~47.98)(均P<0.05)。 两组近端切缘距离、远端切缘距离和术后并发症发生率方面的差异无统计学意义(WMD=0.05, 95% CI=-0.11~0.20;WMD=0.30,95% CI=-0.28~0.88;OR=0.97,95% CI=0.79~1.19)(均P>0.05)。 结论:RG 治疗胃癌安全可行,可取得与LG 相当或更佳的近期疗效和肿瘤根治效果。


Robotic versus laparoscopic gastrectomy for gastric cancer: a Meta-analysis of short-term results

Abstract

Objective: To systematically evaluate the safety, efficacy and short-term results of robotic gastrectomy (RG) for gastric cancer. Methods: The literature in both Chinese and English regarding studies comparing RG and laparoscopic gastrectomy (LG) published between January 2005 and January 2015 were searched from national and international databases. Meta-analysis was performed by using RevMan 5.3 software. Results: Fifteen studies were finally included involving 5 286 patients, of whom 1 618 cases underwent RG (RG group) and 3 668 cases underwent LG (LG group). Results of Meta-analysis indicated that in RG group compared with LG group, the intraoperative blood loss was significantly reduced (WMD=–38.79, 95% CI=–53.73––23.84), number of dissected lymph nodes was increased (WMD=2.13, 95% CI=1.45–2.80), time to first flatus and oral intake, and length of hospital stay were shortened (WMD=–0.27, 95% CI=-0.37––0.16; WMD=–0.25, 95% CI=–0.37––0.14; WMD=–0.82, 95% CI=–1.32––0.32), but the operative time was significantly prolonged (WMD=37.39, 95% CI=26.79–47.98) (all P<0.05). There was no significant difference in the length of proximal and distal resection margin, or incidence of postoperative complications between the two groups (WMD=0.05, 95% CI=–0.11–0.20; WMD=0.30, 95% CI=–0.28–0.88; OR=0.97, 95% CI=0.79–1.19) (all P>0.05). Conclusion: RG is safe and feasible in treatment of gastric cancer, and can achieve comparable or better shortterm and radical effect than LG.


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引用

引用本文: 国锋 吉, 有茂 陶, 涛 张, 刚 王, 俊成 李, 少龙 戚, 冲 马. 机器人与腹腔镜手术治疗胃癌的近期疗效对比Meta 分析[J]. 中国普通外科杂志, 2015, 24(4): 538-546.
Cite this article as: JI Guofeng, TAO Youmao, ZHANG Tao, WANG Gang, LI Juncheng, QI Shaolong, MA Chong . Robotic versus laparoscopic gastrectomy for gastric cancer: a Meta-analysis of short-term results[J]. Chin J Gen Surg, 2015, 24(4): 538-546.