PDF(Pubmed)
Abstract：
Breast reconstruction is an integral part of breast cancer management. Conventional techniques of flap harvesting for autologous breast reconstruction are associated with considerable complications. Robotic surgery has enabled a new spectrum of minimally invasive breast surgeries. The current systematic review and meta-analysis study was designed to retrieve the surgical and clinical outcomes of robotic versus conventional techniques for autologous breast reconstruction. An extensive systematic literature review was performed from inception to 25 April 2023. All clinical studies comparing the outcomes of robotic and conventional autologous breast reconstruction were included for meta-analysis. The present meta-analysis included seven articles consisting of 783 patients. Of them, 263 patients received robotic breast reconstruction, while 520 patients received conventional technique. Of note, 477 patients received latissimus dorsi flap (LDF) and 306 were subjected to deep inferior epigastric artery perforator (DIEP) flap. There was a significantly prolonged duration of surgery (MD 58.36;95% CI 32.05,84.67;P < 0.001) and duration of anaesthesia (MD 47;95% CI 16.23,77.77;P = 0.003) among patients who underwent robotic surgery. There was a similar risk of complications between robotic and conventional surgeries. The mean level of pain intensity was significantly lower among patients who received robotic breast surgery (MD- 0.28;95% CI - 0.73,0.17; P = 0.22). There was prolonged length of hospitalization among patients with conventional DIEP flap surgery (MD- 0.59;95% CI - 1.13,- 0.05;P = 0.03). The present meta-analysis highlighted the feasibility, safety, and effectiveness of robotic autologous breast reconstruction. This included the successful harvesting of LDF and DIEP flap with acceptable surgical and functional outcomes.
摘要：
乳房重建是乳腺癌管理的一个组成部分。用于自体乳房重建的皮瓣收获的常规技术与相当大的并发症相关。机器人手术使微创乳腺手术成为可能。当前的系统评价和荟萃分析研究旨在检索机器人与传统技术用于自体乳房重建的手术和临床结果。从开始到2023年4月25日进行了广泛的系统文献综述。所有比较机器人和常规自体乳房重建结果的临床研究均纳入荟萃分析。本荟萃分析包括7篇文章，由783名患者组成。其中,263例患者接受了机器人乳房重建，而520名患者接受了常规技术。值得注意的是，477例患者接受背阔肌皮瓣（LDF），306例接受腹壁下动脉穿支（DIEP）皮瓣。在接受机器人手术的患者中，手术持续时间显着延长（MD58.36;95％CI32.05,84.67;P<0.001）和麻醉持续时间（MD47;95％CI16.23,77.77;P=0.003）。机器人手术和传统手术之间存在类似的并发症风险。在接受机器人乳房手术的患者中，疼痛强度的平均水平显着降低（MD-0.28;95％CI-0.73,0.17;P=0.22）。传统DIEP皮瓣手术患者的住院时间延长（MD-0.59；95％CI-1.13，-0.05；P=0.03）。本荟萃分析强调了这一可行性，安全,机器人自体乳房重建的有效性。这包括成功收获具有可接受的手术和功能结果的LDF和DIEP皮瓣。
