| 张新军,于俊康,朱金慧,魏海波,孟柠,胡铭荣.单侧腋窝入路机器人对比腔镜甲状腺手术疗效的meta分析[J].浙江中西医结合杂志,2022,32(11): |
| 单侧腋窝入路机器人对比腔镜甲状腺手术疗效的meta分析 |
| A meta-analysis of unilateral axillary approach for robotic surgery compared with endoscopic surgery for thyroid diseases |
| 投稿时间：2022-06-11 修订日期：2022-10-09 |
| DOI： |
| 中文关键词: 单侧腋窝入路 机器人 腔镜 甲状腺手术 meta分析 |
| 英文关键词:Unilateral Axillary Approach Robotic Endoscopy Thyroidectomy Meta-analysis |
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| 中文摘要: |
| 目的:系统评价单侧腋窝入路机器人甲状腺手术对比腔镜手术的疗效。方法:检索PubMed,Embase、Cochrane Library、Web of Science、中国知网、中国生物医学文献数据库、万方、维普数据库,查找符合标准的相关文献,使用RevMan 5.3软件对单侧腋窝入路机器人甲状腺手术对比腔镜手术相关的12项指标进行meta分析。结果:纳入8项研究,均为英文文献,共3604例患者。Meta分析结果显示：机器人组与腔镜组相比,暂时性喉返神经损伤率更低(RR=0.66,95％CI:0.47～0.93,P＜0.05),永久性低钙血症发生率更低(P＜0.05),淋巴结清扫数目更多(WMD=0.82,95％CI:0.04～1.59,P＜0.05)；而永久性喉返神经损伤、暂时性低钙血症、气管损伤率、臂丛神经损伤率、手术时间、住院时间、术后血肿、术后切口积液及淋巴漏发生率,两组间的差异均无统计学意义(P＞0.05)。结论: 单侧腋窝入路机器人甲状腺手术与腔镜手术相比，手术并发症更少，清扫颈淋巴结可能更具优势。需前瞻性随机对照试验进一步验证。 |
| 英文摘要: |
| Objective:To systematically evaluate the efficacy between robotic surgery and endoscopic surgery for thyroid disease via unilateral transaxillary approach.Methods:PubMed, Embase, Cochrane Library, Web of Science, CNKI, CBM, Wanfang and VIP databases were utilized to search for relevant literatures that met the standards, and a meta-analysis was performed on 12 indicators using RevMan software version 5.3. Results: 8 studies with a total of 3604 patients were included in the meta-analysis, all of which were English literature. Results showed that compared with endoscopic group, the robotic group had a lower rate of temporary recurrent laryngeal nerve injury (RR= 0.66,95% CI: 0.47～0.93, P<0.05), a lower incidence of permanent hypocalcemia (P<0.05) and more retrieved lymph nodes(WMD = 0.82,95% CI: 0.04～1.59,P<0.05). In contrast, there were no statistically significant difference in permanent recurrent laryngeal nerve injury,temporary hypocalcemia,tracheal injury,brachial plexus injury,operation time,hospitalization time,hematoma,seroma and lymphatic leakage between the two groups(p>0.05). Conclusions: Compared with endoscopic surgery, robotic thyroidectomy via unilateral transaxillary approach may have fewer surgical complications and more advantages in neck lymph node dissection. Further validation is required in a prospective randomized controlled trial. |
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