【摘要】：[目的]本研究通過系統(tǒng)分析達芬奇機器人與腹腔鏡胃癌手術(shù)的臨床對比研究來評價達芬奇機器人胃癌手術(shù)的近遠期療效與安全性。[方法]通過 PubMed,Medline,Cochrane labrary,Embase,SPRINGER,Elsevier,Web of Science,VIP,數(shù)字化期刊全文數(shù)據(jù)庫(萬方),相關(guān)期刊論文(CNKI),中國生物醫(yī)學(xué)文獻數(shù)據(jù)庫(CBM),檢索2000年-2017年1月8日機器人與腹腔鏡胃癌手術(shù)對比的文獻。比較兩組的手術(shù)時間、術(shù)中失血量等數(shù)據(jù)。對獲得的數(shù)據(jù)選用RevMan5.2軟件進行處理,依據(jù)數(shù)據(jù)異質(zhì)性來選取固定效應(yīng)模型或者隨機效應(yīng)模型進行meta分析。[結(jié)果]共納入17篇文獻包含5787人(機器人手術(shù)組1676人,腹腔鏡手術(shù)組4111人)。meta分析結(jié)果顯示:與傳統(tǒng)腹腔鏡組相比,機器人組的手術(shù)時間更長(WMD=43.51,95%CI[34.14,52.88],P0.05)、術(shù)中失血量更少(WMD=-30.17,95%CI[-42.83,-17.51],P0.05)、淋巴結(jié)清掃數(shù)目更多(WMD=1.95,95%CI[0.07,3.84],P0.05)、首次進食時間更早(WMD=-0.22,95%CI[-0.32,-0.12],P0.05)、患者年齡更小(WMD=-2.24,95%CI[-3.58,-0.89],P0.05)。兩組的近端切緣距離、遠端切緣距離、R0切除率、術(shù)后首次排氣時間、術(shù)后并發(fā)癥發(fā)生率、術(shù)后住院時間、3年生存率、死亡率均無明顯差異(P0.05)。[結(jié)論]達芬奇機器人胃癌手術(shù)安全、有效,且有較好的近遠期療效。
[Abstract]:[objective] to evaluate the efficacy and safety of da Vinci robot gastric cancer surgery by analyzing the clinical comparative study of da Vinci robot and laparoscopic gastric cancer surgery. [methods] the PubMed,Medline,Cochrane labrary,Embase,SPRINGER,Elsevier,Web of Science,VIP, digital full text journal database (Wanfang) and the Chinese journal full-text database (CNKI), Chinese biomedical literature database (CBM), were used to search the literatures of robot and laparoscopic gastric cancer surgery from 2000 to 2017. The operation time and blood loss were compared between the two groups. RevMan5.2 software is used to process the obtained data. According to the heterogeneity of the data, the fixed effect model or random effect model is selected for meta analysis. [results] A total of 17 articles included 5787 people (1676 in the robotic surgery group and 4111 in the laparoscopic group). The results of meta analysis showed that: compared with the traditional laparoscopic group, The robot group had longer operation time (WMD=43.51,95%CI [34.14 鹵52.88] P 0.05), less blood loss during operation (WMD=-30.17,95%CI [-42.83 -17.51] P 0.05), more lymph node dissection (WMD=1.95,95%CI [0.07 鹵3.84] P 0.05), earlier time of first feeding (WMD=-0.22,95%CI [-0.32 -0.12] P 0.05) and younger age (WMD=-2.24,95%CI [-3.58% -0.89] P 0.05). There was no significant difference between the two groups in the distance between proximal and distal incisal margin and the rate of R0 resection, the first time of exhaust after operation, the incidence of postoperative complications, the postoperative hospitalization time, the 3-year survival rate and the mortality rate (P0.05). Conclusion: da Vinci robot gastric cancer surgery is safe, effective and has good short-and long-term effect.
【學(xué)位授予單位】：昆明醫(yī)科大學(xué)
【學(xué)位級別】：碩士
【學(xué)位授予年份】：2017
【分類號】：R735.2

【參考文獻】

相關(guān)期刊論文 前10條

1 余佩武;陳凜;曹暉;程龍偉;陳敏;杜曉輝;胡建昆;何裕隆;郝迎學(xué);賈寶慶;姜可偉;揭志剛;江志偉;柯重偉;李紀(jì)鵬;李太原;錢鋒;蘇向前;石彥;孫益紅;陶凱雄;譚敏;王康;許劍民;徐澤寬;燕敏;袁維堂;葉穎江;鐘鳴;周巖冰;趙永亮;陳軍;李平昂;;機器人胃癌手術(shù)專家共識(2015版)[J];中國研究型醫(yī)院;2016年01期

2 李鵬;李冰;劉洪一;賈寶慶;;達芬奇機器人手術(shù)系統(tǒng)在胃癌中的應(yīng)用[J];臨床與病理雜志;2015年06期

3 吉國鋒;陶有茂;張濤;王剛;李俊成;戚少龍;馬沖;;機器人與腹腔鏡手術(shù)治療胃癌的近期療效對比Meta分析[J];中國普通外科雜志;2015年04期

4 杜曉輝;;腹腔鏡和達芬奇機器人系統(tǒng)在胃腸外科中的應(yīng)用[J];上海醫(yī)藥;2014年23期

5 李進權(quán);虞黎明;賴斌;張兵;朱培謙;;機器人系統(tǒng)及腹腔鏡輔助行胃癌根治術(shù)治療胃癌近期療效對比Meta分析[J];中國實用外科雜志;2014年12期

6 劉永永;王琛;康迎新;李徐生;樊勇;康博雄;趙彥會;;機器人與腹腔鏡行胃癌手術(shù)近期療效比較的Meta分析[J];腹腔鏡外科雜志;2014年07期

7 劉江;阮虎;趙坤;王剛;李民;江志偉;;達芬奇機器人與腹腔鏡行胃癌根治術(shù)的對照研究[J];中華胃腸外科雜志;2014年05期

8 陸日克;李國星;韋寶甘;;腹腔鏡與開腹胃癌根治術(shù)遠期療效和安全性的比較[J];中國普通外科雜志;2014年04期

9 金振宇;;中國達芬奇手術(shù)機器人臨床應(yīng)用[J];中國醫(yī)療器械雜志;2014年01期

10 杜曉輝;方國吉;寧寧;馬冰;楊華夏;劉慶;張鼎;;腹腔鏡直腸癌全直腸系膜切除術(shù)的學(xué)習(xí)曲線研究[J];中華腔鏡外科雜志(電子版);2013年01期

，

本文編號：2235385