机器人与腹腔镜手术治疗胃癌的近期疗效对比Meta 分析
| 作者: |
1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 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: |
马冲
Email: machong1966@163.com |
| DOI: | 10.3978/.10.3978/j.issn.1005-6947.2015.04.015 |
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。
关键词：
胃肿瘤
胃切除术
机器人
腹腔镜
Meta 分析
Robotic versus laparoscopic gastrectomy for gastric cancer: a Meta-analysis of short-term results
CorrespondingAuthor:MA Chong Email: machong1966@163.com
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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