机器人辅助腹腔镜行左半结肠癌根治性切除术安全性与有效性的Meta分析

目的荟萃分析机器人辅助腹腔镜左半结肠癌根治性切除术（RA）与传统腹腔镜左半结肠癌根治性切除术（LA）的安全性与有效性。 方法检索中国知网、万方数据库、PubMed、NCBI等数据库建库至2021年5月报道的RA和LA的对照研究。由两名研究人员独立进行相关研究数据提取和相关文献内容收集，并应用Revman 5.3软件对所收集数据进行分析。 结果共纳入10项回顾性分析研究，涉及4 770例左半结肠癌病例，其中RA 2 309例，LA 2 461例。与LA组相比，RA组住院时间短（MD=-0.74，95% CI：-1.33~-0.16，P=0.01），住院费用高（MD=1.02，95% CI：0.04~2.00，P=0.04），术中出血量少（MD=-13.49，95% CI：-20.91~-6.06，P<0.001），中转开腹率低（OR=0.55，95% CI：0.45~0.69，P<0.001），清扫淋巴结数量差异无统计学意义（MD=-0.20，95% CI：-2.64~2.24，P=0.87），手术时间长（MD=42.64，95% CI：13.53~71.74，P=0.004），术后排气时间早（MD=-0.29，95% CI：-0.49~-0.09，P=0.004），术后进食时间早（MD=-0.30，95% CI：-0.51~-0.09，P=0.005），并发症发生率差异无统计学意义（OR=0.78，95% CI：0.60~1.01，P=0.06）。 结论RA安全可行，术后患者胃肠功能恢复更快，但在手术时间、清扫淋巴结数量和并发症发生率方面无明显优势。

Safety and effectiveness of robot-assisted laparoscopic radical resection of left colon cancer: A Meta-analysis

ObjectiveTo conduct a Meta-analysis of the safety and efficacy of robot-assisted laparoscopic radical resection of left colon cancer (RA) versus traditional laparoscopic-assisted radical resection of left colon cancer (LA). MethodsThrough CNKI, Wanfang Database, PubMed, NCBI and other databases, the control studies of RA and LA were retrieved from the database establishment to May 2021. Two researchers independently extracted relevant research data and collected relevant literature content, and Revman 5.3 software was used to analyze the collected data. ResultsA total of 10 retrospective studies involving 4 770 cases of left colon cancer were included, including 2 309 cases of RA and 2 461 cases of LA. Compared to the LA group, the patients in RA group had shortert hospital stay (MD=-0.74, 95% CI: -1.33, -0.16; P=0.01), higher hospitalization cost (MD=1.02, 95% CI: 0.04, 2.00; P=0.04), less intraoperative bleeding (MD=-13.49, 95% CI: -20.91, -6.06; P<0.001), longer operation time (MD=42.64, 95% CI: 13.53, 71.74; P=0.004), earlier postoperative exhaust (MD=-0.29, 95% CI: -0.49, -0.09; P=0.004), earlier postoperative feeding time (MD=-0.30, 95% CI: -0.51, -0.09; P=0.005), and the conversion rate to open surgery was lower (OR=0.55, 95% CI: 0.45, 0.69; P<0.001). There were no significant differences in the number of dissected lymph nodes (MD=-0.20, 95% CI: -2.64, 2.24; P=0.87), the incidence of complications (OR=0.78, 95% CI: 0.60, 1.01; P=0.06). ConclusionRA is safe and feasible, and postoperative gastrointestinal function of patients can recover faster, but it has no significant advantage in terms of operation time, the number of dissected lymph nodes and incidence of complications.