Abstract：
Examine the role, benefits, and limitations of robotic surgery in myomectomies compared to laparoscopic and open surgical approaches. This review sourced data from CENTRAL, Pubmed, Medline, and Embase up until May 1, 2023. Full articles comparing clinical outcomes of robotic myomectomy with open or laparoscopic procedures were included without language restriction. Initially, 2150 records were found. 24 studies were finally included for both qualitative and quantitative analyses. Two investigators independently assessed all reports following PRISMA guidelines. Meta-analysis was conducted using the software \"Review Manager Version 5.4\". Risk-of-bias was assessed using the Newcastle-Ottawa scale. Sensitivity analysis was conducted, when feasible. In a comparison between robotic and laparoscopic myomectomies, no significant difference was observed in fibroid weights and the size of the largest fibroid. Robotic myomectomy resulted in less blood loss, but transfusion rates were comparable. Both methods had similar complication rates and operative times, although some robotic studies showed longer durations. Conversion rates favored robotics. Hospital stays varied widely, with no overall significant difference, and pregnancy rates were similar between the two methods. When comparing robotic to open myomectomies, open procedures treated heavier and larger fibroids. They also had greater blood loss, but the robotic approach required fewer transfusions. The complication rate was slightly higher in open procedures. Open surgeries were generally faster, postoperative pain scores were similar, but hospital stays were longer for open procedures. Pregnancy rates were comparable for both robotic and open methods. Robotic surgery offers advancement in myomectomy procedures by offering enhanced exposure and dexterity, leading to reduced blood loss and improved patient outcomes. PROSPERO registration: CRD42023462348.
摘要：
检查角色，好处,与腹腔镜和开放手术方法相比，机器人手术在子宫肌瘤切除术中的局限性。这篇评论的数据来自CENTRAL，Pubmed,Medline,和Embase直到2023年5月1日。包括比较机器人子宫肌瘤切除术与开放式或腹腔镜手术的临床结果的完整文章，没有语言限制。最初，找到2150条记录。最终包括24项研究进行定性和定量分析。两名研究者根据PRISMA指南独立评估所有报告。使用软件“ReviewManagerVersion5.4”进行Meta分析。使用纽卡斯尔-渥太华量表评估偏倚风险。进行了敏感性分析，当可行时。在机器人和腹腔镜子宫切除术之间的比较中，在肌瘤重量和最大肌瘤的大小方面没有观察到显着差异。机器人子宫肌瘤切除术减少了失血，但输血率相当。两种方法的并发症发生率和手术时间相似，尽管一些机器人研究显示持续时间更长。转化率有利于机器人。医院的住院情况千差万别，总体上没有显著差异，两种方法的妊娠率相似。当比较机器人和开放式子宫切除术时，开放手术治疗更重和更大的肌瘤。他们失血也更多，但是机器人方法需要更少的输血。开放手术的并发症发生率略高。开放手术通常更快，术后疼痛评分相似,但是开放手术的住院时间更长。机器人和开放式方法的妊娠率相当。机器人手术通过提供增强的暴露和灵活性，在子宫肌瘤切除术中提供了进步，导致减少失血和改善患者预后。PROSPERO注册：CRD42023462348。
