【摘要】：[目的]本研究通過(guò)系統(tǒng)分析達(dá)芬奇機(jī)器人與腹腔鏡胃癌手術(shù)的臨床對(duì)比研究來(lái)評(píng)價(jià)達(dá)芬奇機(jī)器人胃癌手術(shù)的近遠(yuǎn)期療效與安全性。[方法]通過(guò) PubMed,Medline,Cochrane labrary,Embase,SPRINGER,Elsevier,Web of Science,VIP,數(shù)字化期刊全文數(shù)據(jù)庫(kù)(萬(wàn)方),相關(guān)期刊論文(CNKI),中國(guó)生物醫(yī)學(xué)文獻(xiàn)數(shù)據(jù)庫(kù)(CBM),檢索2000年-2017年1月8日機(jī)器人與腹腔鏡胃癌手術(shù)對(duì)比的文獻(xiàn)。比較兩組的手術(shù)時(shí)間、術(shù)中失血量等數(shù)據(jù)。對(duì)獲得的數(shù)據(jù)選用RevMan5.2軟件進(jìn)行處理,依據(jù)數(shù)據(jù)異質(zhì)性來(lái)選取固定效應(yīng)模型或者隨機(jī)效應(yīng)模型進(jìn)行meta分析。[結(jié)果]共納入17篇文獻(xiàn)包含5787人(機(jī)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(jī)器人組的手術(shù)時(shí)間更長(zhǎng)(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(jìn)食時(shí)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(yuǎn)端切緣距離、R0切除率、術(shù)后首次排氣時(shí)間、術(shù)后并發(fā)癥發(fā)生率、術(shù)后住院時(shí)間、3年生存率、死亡率均無(wú)明顯差異(P0.05)。[結(jié)論]達(dá)芬奇機(jī)器人胃癌手術(shù)安全、有效,且有較好的近遠(yuǎn)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(jí)別】：碩士
【學(xué)位授予年份】：2017
【分類(lèi)號(hào)】：R735.2

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