机器人和腹腔镜右半结肠切除术近期疗效的Meta分析

Comparision of Short-Term Efficacy of Robotic and Laparoscopic Right Hemicolectomy: A Meta-Analysis

摘要: 目的：通过Meta分析的方法比较机器人右半结肠切除术与腹腔镜右半结肠切除术之间的近期疗效。方法：检索检索包括Pubmed、Cochrane Library、EMBASE、中国生物医学文献数据库(CBM)、中国知网(CNKI)、万方、维普数据库在内的数据库。检索时间为建库至2023年8月。用NOS评分系统评价文献质量。用Review Manager5.3软件进行统计分析。结果：最终纳入符合标准的相关文献16篇纳入病例总数10596例，其中RRC组873例、LRC组9723例。与LRC组相比，RRC组手术时间平均多(WMD = 43.23, 95% CI = 27.65~58.81, P < 0.00001)、住院时间缩短(WMD = −0.94，95%CI = −1.14~−0.74，P < 0.00001)、中转开腹率低(WMD = 0.58, 95% CI = 0.38~0.89, P = 0.01)，差异有统计学意义(P < 0.05)；术后首次排气时、术后首次进食时间，术中失血量、淋巴结获取数目、总并发症发生，以及术后肠梗阻、心肺系统并发症、吻合口瘘和切口感染等并发症方面，差异无统计学意义。结论：机器人右半结肠切除术可以缩短住院时间、降低中转开腹率，会延长手术时间。但在术后首次排气时、术后首次进食时间，术中失血量、淋巴结获取数目、总并发症发生的差异无统计学意义。

Abstract: A meta-analysis was conducted to evaluate and compare the short-term efficacy between robotic and laparoscopic right colectomy. Methods: A literature search was performed including Pubmed, Cochrane Library、EMBASE, Chinese Biomedical Literature Database (CBM), Chinese CNKI, Wanfang and Weipu. The retrieval time was set up to April 2023. NOS score system was used to evaluate literature quality. Statistical analysis was performed using Review Management 5.3 software. Results: There were 16 relevant literatures that met the standards, a total of 10596 patients were included. There were 873 cases in RRC group and 9723 cases in LRC group. Compared with the LRC group, the average operation time in the RRC group was longer (WMD = 43.23, 95% CI = 27.65~58.81, P < 0.00001) and the length of hospital stay was shorter (WMD = −0.94, 95% CI = −1.14~0.74). P < 0.00001), the conversion rate of laparotomy was low (WMD = 0.58, 95% CI = 0.38-0.89, P = 0.01), the difference was statistically significant (P < 0.05).There were no statistically significant differences between the two groups in the time of the first postoperative exhaust, the time of the first postoperative feeding, the amount of intraoperative blood loss, the number of lymph nodes acquired, the incidence of total complications, and postoperative complications such as intestinal obstruction, cardiopulmonary complications, anastomotic fistula and incision infection. Conclusion: Robotic-assisted right colectomy can shorten the length of hospital stay, reduce the conversion rate of laparotomy, and extend the operation time. However, there were no significant differences in the time of first postoperative exhaust, the time of first postoperative feeding, the amount of blood loss, the number of lymph nodes obtained and the occurrence of total complications.