文献类型：期刊文献

英文题名：Robotic-assisted minimally invasive esophagectomy versus the conventional minimally invasive one: A meta-analysis and systematic review

作者：Jin, Dacheng[1,2,3,4];Yao, Liang[5,6];Yu, Jun[2];Liu, Rong[5];Guo, Tiankang[3];Yang, Kehu[3,4];Gou, Yunjiu[2]

第一作者：Jin, Dacheng

通信作者：Gou, YJ[1];Yang, KH[2]

机构：[1]Gansu Univ Tradit Chinese Med, Dept Clin Med, Lanzhou, Gansu, Peoples R China;[2]Gansu Prov Peoples Hosp, Dept Thorac Surg, Lanzhou, Gansu, Peoples R China;[3]Gansu Prov Peoples Hosp, Inst Clin Res & Evidence Based Med, Lanzhou, Gansu, Peoples R China;[4]Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Gansu, Peoples R China;[5]Chinese Peoples Liberat Army Gen Hosp, Dept Hepatobiliary Surg 2, Beijing, Peoples R China;[6]Hong Kong Baptist Univ, Clin Div, Hong Kong, Peoples R China

第一机构：甘肃中医药大学临床医学院

通信机构：[1]corresponding author), Gansu Prov Peoples Hosp, Lanzhou, Gansu, Peoples R China;[2]corresponding author), Lanzhou Univ, Lanzhou, Gansu, Peoples R China.

年份：2019

卷号：15

期号：3

外文期刊名：INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY

收录：;EI(收录号：20223012430500);Scopus(收录号：2-s2.0-85063728108);WOS:【SCI-EXPANDED(收录号:WOS:000463914800007)】；

基金：The authors thank Liang Yao, Peijing Yan (Clinical Research and Evidence Based Medicine of Gansu Province People's Hospital) for their help and support in the methodology and meta process. This work was supported by Health Industry Plan of GanSu Province (grant number GSWSKY2017-56) and the Hospital Internal Scientific Research Foundation of Gansu Province People's Hospital (grant number 16GSSY3-1).

语种：英文

外文关键词：Diseases - Hospitals - Population statistics - Virtual reality

摘要：BackgroundConventional video-assisted minimally invasive esophagectomy (MIE) is safe and associated with low rates of morbidity and mortality, but the two-dimensional monitor reduces eye-hand harmony and viewing yield. Robotic-assisted minimally invasive esophagectomy (RAMIE) with its virtual reality simulators offers a realistic three-dimensional environment that facilitates dissection in the narrow working space, but it is expensive and requires longer operative time. Therefore, the aim of this meta-analysis was to assess the safety and feasibility of RAMIE versus MIE in patients with esophageal cancer. Material and MethodsPubMed, EMBASE, Cochrane library, and Chinese Biomedical Literature databases were systematically searched up to 21 September 2018 for case-controlled studies that compared RAMIE with MIE. ResultEight case-controlled studies involving 1862 patients (931 under RAMIE and 931 under MIE) were considered. No statistically significant difference between the two techniques was observed regarding R0 resection rate (OR=1.1174, P=0.8647), conversion to open (OR=0.7095, P=0.7519), 30-day mortality rate (OR=0.8341, P=0.7696), 90-day mortality rate (OR=0.3224, P=0.3329), in-hospital mortality rate (OR=0.3733, P=0.3895), postoperative complications, number of harvested lymph nodes (mean difference [MD]=0.8216, P=0.2039), operation time (MD=24.3655min, P=0.2402), and length of stay in hospitals (LOS) (MD=-5.0228day, P=0.1342). The meta-analysis showed that RAMIE was associated with a significantly fewer estimated blood loss (EBL) (MD=-33.2268mL, P=0.0075). And the vocal cord palsy rate was higher in the MIE group compared with RAMIE, and the difference was significant (OR=0.5696, P=0.0447). ConclusionThis meta-analysis indicated that RAMIE and MIE display similar feasibility and safety when used in esophagectomy. However, randomized controlled studies with larger sample sizes are needed to evaluate the benefit and harm in patients with esophageal cancer undergoing RAMIE.