机器人辅助腹腔镜子宫切除术与常规腹腔镜和开腹子宫切除术治疗子宫内膜癌的比较安全性和有效性的系统评价和荟萃分析

机器人辅助腹腔镜子宫切除术与常规腹腔镜和开腹子宫切除术治疗子宫内膜癌的比较安全性和有效性的系统评价和荟萃分析
Comparative safety and effectiveness of robot-assisted laparoscopic hysterectomy versus conventional laparoscopy and laparotomy for endometrial cancer- A systematic review and meta-analysis

                               
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Abstract
摘要
AIM:
目的：
This study aimed to evaluate the surgical safety and clinical effectiveness of RH compared to OH and LH for endometrial cancer.
本研究旨在评估外科手术的安全性RH相比，OH和LH对子宫内膜癌的临床效果。

METHODS:
方法:
We searched Ovid-Medline, Ovid-EMBASE, and the Cochrane library for studies published through May 2015. The outcomes of interest included safety (overall; peri-operative and post-operative complications; death within 30-days; and specific morbidities), effectiveness (survival, recurrence, length of stay [LOS], estimated blood loss [EBL], and operative time [OT]), and patient-reported outcomes (pain score, pain medication use, length of pain medication use, and time to return to work). Two independent reviewers extracted data and assessed the risk of bias.
我们通过搜索Ovid-Medline，Ovid-EMBASE，和Cochrane图书馆2015年发表的研究。感兴趣的结果包括安全性（整体；围手术期和术后并发症；30天内死亡；和特定的疾病）、有效性（生存、复发、住院时间[LOS]，估计失血量[EBL]，和手术时间[OT]），和病人报告的结果（疼痛评分、止痛药的使用、止痛药物使用，长度和返回工作时间）。两个独立的评价者提取数据和评估偏差的风险。

RESULTS:
结果:
Twenty-four studies comparing RH to OH and 24 comparing RH to LH were identified. No significant differences were found in survival outcomes. The LOS was shorter, there was less EBL, and the rates of complications, readmission, and transfusion were lower with RH compared to OH. However, RH showed a longer OT and a higher incidence of vaginal cuff dehiscence compared to those for OH. Compared to LH, the LOS was shorter, there was less EBL, and the rates of conversion to laparotomy, intra-operative complications, urinary tract injuries, and cystotomy were lower in RH. Several patient-reported outcomes showed a significant benefit of RH, but each outcome was reported in only one study.
二十四项研究比较RH至OH和24项比较RH到LH进行鉴定。没有发现显著差异在生存的结果。在LOS较短，较少EBL和并发症，再住院、输血的速度相比，与OH相对湿度较低。然而，RH显示较长的OT与较高的发病率相比，阴道穹窿裂开高于OH。相比LH，LOS短、有更少的EBL、和中转开腹率、术中并发症、尿道损伤、和膀胱切开术的机率RH相对较低。一些患者报告的结果显示，RH的优势显著，但每个结果只有一个研究报告。

CONCLUSIONS:
结论：
RH may be a generally safer and better option than OH and LH for patients with endometrial cancer. Further prospective studies with long-term follow-up are required.
RH 相对于OH和LH为子宫内膜癌患者，可能是一个普遍更安全、更好的选择。需要长期后续的进一步的前瞻性研究。

原文：
Comparative safety and effectiveness of robot-assisted laparoscopic hysterectomy.pdf (556.41 KB, 下载次数: 0, 售价: 99 香叶)

2016-8-30 08:02 上传

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机器人辅助腹腔镜子宫切除术与常规腹腔镜和开腹子宫切除术治疗子宫内膜癌的比较安全性和有效性的系统评价和 ...