文献类型：期刊文献

中文题名：机器人辅助子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术疗效对比的Meta分析

英文题名：Meta-analysis of the Efficacy of Robot-assisted Myomectomy Compared with Laparoscopic-assisted Myomectomy

作者：盛燕楠[1,2];王剑[2];毛宝宏[2];吴珍珍[2];刘青[2]

第一作者：盛燕楠

机构：[1]甘肃中医药大学第一临床医学院,甘肃兰州730000;[2]甘肃省妇幼保健院妇产科,甘肃兰州730000

第一机构：甘肃中医药大学临床医学院

年份：2023

卷号：39

期号：2

起止页码：147

中文期刊名：实用妇产科杂志

外文期刊名：Journal of Practical Obstetrics and Gynecology

收录：CSTPCD;;北大核心:【北大核心2020】；CSCD:【CSCD_E2023_2024】；

基金：甘肃省自然科学基金(21JR1RA043);甘肃省科技计划项目(21JR11RA166)。

语种：中文

中文关键词：机器人;腹腔镜;子宫肌瘤;子宫肌瘤剔除术;Meta分析

外文关键词：Robotics;Laparoscopes;Uterine fibroids;Myomectomy;Meta-analysis

摘要：目的:系统评价机器人辅助子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术的疗效。方法:计算机检索PubMed、Embase、The Cochrane Library、Web of Science、万方数据库、维普数据库和中国知网(CNKI)数据库,搜索建库至2022年3月公开发表的比较机器人辅助子宫肌瘤剔除术与腹腔镜子宫肌瘤剔除术疗效的相关文献,采用Review Manager 5.4软件对文献进行Meta分析。结果:共纳入19篇文献,共计45870例患者,机器人组11682例,腹腔镜组34188例。Meta分析结果显示,与腹腔镜子宫肌瘤剔除术相比,机器人辅助子宫肌瘤剔除术术中出血量更少((印)MD(正)-24.67,95%CI-41.91~-7.43,(印)P(正)=0.005),输血发生率更低((印)OR(正)0.86,95%CI 0.77~0.97,(印)P(正)=0.01),住院时间更短((印)MD(正)-0.38,95%CI-0.73~-0.04,(印)P(正)=0.03),中转开腹率更低((印)OR(正)0.82,95%CI 0.73~0.92,(印)P(正)=0.0006),且术后并发症发生率更低((印)OR(正)0.58,95%CI 0.40~0.86,(印)P(正)=0.006);但在手术时间((印)MD(正)34.82,95%CI 18.87~50.77,(印)P(正)<0.0001)方面腹腔镜子宫肌瘤剔除术更具优势;两种手术方式最大肌瘤直径差异无统计学意义((印)MD(正)0.36,95%CI-0.02~0.74,(印)P(正)=0.07)。结论:机器人辅助子宫肌瘤剔除术在术中出血量、输血发生率、住院时间、中转开腹率和术后并发症方面比腹腔镜子宫肌瘤剔除术更具优势;而腹腔镜子宫肌瘤剔除术比机器人辅助子宫肌瘤剔除术在手术时间方面更具优势。
Objective:To systematically evaluate the efficacy of robotic-assisted myomectomy versus laparoscopic-assisted myomectomy.Methods:PubMed,Embase,The Cochrane Library,Web of Science,Wanfang database,VIP database and CNKI database were searched by computer to seek relevant literatures in order to compare the efficacy of robotic-assisted myomectomy with that of laparoscopic-assisted myomectomy from the establishment of the databases to March 2022,and Review Manager 5.4 software was utilized to perform a Meta-analysis of the literatures.Results:A total of 19 retrospective clinical controlled studies were included.There was a total of 45870 patients,including 11682 patients in the robot group and the remaining 34188 patients in the laparoscopic group.Meta-analysis results revealed that robotic-assisted myomectomy was associated with less intraoperative bleeding(MD-24.67,95%CI-41.91--7.43,P=0.005),lower incidence of blood transfusion(OR 0.86,95%CI 0.77-0.97,P=0.01),shorter postoperative hospital stay(MD-0.38,95%CI-0.73--0.04,P=0.03),fewer transition to open stomach(OR 0.82,95%CI 0.73-0.92,P=0.0006)and lower incidence of post-operative complications(OR 0.58,95%CI 0.40-0.86,P=0.006)than laparoscopic-assisted myomectomy;whereas,laparoscopic-assisted myomectomy was more advantageous in terms of operating time(MD34.82,95%CI 18.87-50.77,P<0.0001);there was no statistically significant difference between the two surgical approaches in terms of maximum myoma diameter(MD 0.36,95%CI-0.02-0.74,P=0.07).Conclusions:In the aspects of intraoperative bleeding,incidence of blood transfusion,postoperative hospital stay,transit open stomach rate and post-operative complications,robotic-assisted myomectomy has unique advantages than those of laparoscopic-assisted myomectomy,while laparoscopic-assisted myomectomy has advantages over robotic-assisted myomectomy in terms of operating time.