文献类型：期刊文献

英文题名：Robotic-assisted versus laparoscopic cholecystectomy for benign gallbladder diseases: a systematic review and meta-analysis

作者：Han, Caiwen[1,2,5];Shan, Xinyi[1,5];Yao, Liang[5];Yan, Peijing[5];Li, Meixuan[4,5];Hu, Lidong[1,2,5];Tian, Hongwei[1];Jing, Wutang[1];Du, Binbin[1];Wang, Lixia[5];Yang, Kehu[3,5];Guo, Tiankang[1,5]

第一作者：Han, Caiwen

通信作者：Guo, TK[1];Yang, KH[2];Yang, KH[3];Guo, TK[3]

机构：[1]Gansu Prov Hosp, Dept Gen Surg, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[2]Gansu Univ Tradit Chinese Med, Dept Clin Med, Lanzhou 730000, Gansu, Peoples R China;[3]Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, 199 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[4]Lanzhou Univ, Sch Publ Hlth, Lanzhou 730000, Gansu, Peoples R China;[5]Gansu Prov Hosp, Inst Clin Res & Evidence Based Med, Lanzhou 730000, Gansu, Peoples R China

第一机构：Gansu Prov Hosp, Dept Gen Surg, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China

通信机构：[1]corresponding author), Gansu Prov Hosp, Dept Gen Surg, 204 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[2]corresponding author), Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, 199 Donggang West Rd, Lanzhou 730000, Gansu, Peoples R China;[3]corresponding author), Gansu Prov Hosp, Inst Clin Res & Evidence Based Med, Lanzhou 730000, Gansu, Peoples R China.

年份：2018

卷号：32

期号：11

起止页码：4377

外文期刊名：SURGICAL ENDOSCOPY AND OTHER INTERVENTIONAL TECHNIQUES

收录：;Scopus(收录号：2-s2.0-85049134673);WOS:【SCI-EXPANDED(收录号:WOS:000447953200002)】；

基金：Xinyi Shan and Liang Yao gave many suggestions during the revision phase of the paper. The authors would like to thank the institution (Evidence-Based Medicine Center, School of Basic Medical Sciences, Lanzhou University) for their contribution toward the statistical study design and study data analysis.

语种：英文

外文关键词：Cholecystectomy robotic-assisted; Laparoscopic; Meta-analysis

摘要：BackgroundRobotic surgery, an emerging technology, has some potential advantages in many complicated endoscopic procedures compared with laparoscopic surgery. But robot-assisted cholecystectomy (RAC) is still a controversial issue on its comparative merit compared with conventional laparoscopic cholecystectomy (LC). The aim of this study was to evaluate the safety and efficacy of RAC compared with LC for benign gallbladder disease.MethodsA systematic literature search was conducted using the PubMed, EMBASE, and Cochrane Library databases (from their inception to December 2017) to obtain comparative studies assessing the safety and efficacy between RAC and LC. The quality of the literature was assessed, and the data analyzed using R software, random effects models were applied.ResultsTwenty-six studies, including 5 RCTs and 21 NRCSs (3 prospective plus 18 retrospective), were included. A total of 4004 patients were included, of which 1833 patients (46%) underwent RAC and 2171 patients (54%) underwent LC. No significant differences were found in intraoperative complications, postoperative complications, readmission rate, hospital stay, estimated blood loss, and conversion rate between RAC and LC groups. However, RAC was related to longer operative time compared with LC (MD=12.04min, 95% CI 7.26-16.82) in RCT group, which was consistent with NRCS group; RAC also had a higher rate of incisional hernia in NRCS group (RR=3.06, 95% CI 1.42-6.57), and one RCT reported that RAC was similar to LC (RR=7.00, 95% CI 0.38-129.84).ConclusionsThe RAC was not found to be more effective or safer than LC for benign gallbladder diseases, which indicated that RAC is a developing procedure instead of replacing LC at once. Given the higher costs, the current evidence is in favor of LC in cholecystectomy.