UNASSIGNED: A systematic search was conducted in four databases (Medline, Embase, Web of Science, and CENTRAL) for studies comparing the utilization of RRH and LRH in the treatment of cervical cancer. The search included articles published from the inception of the databases up until July 18, 2023. Meta-analyses were conducted to assess several surgical outcomes, including operation time, estimated blood loss, length of hospital stay, pelvic lymph nodes, positive surgical margin, total complications, one-year recurrence rate, one-year mortality, and one-year disease-free survival rate.
UNASSIGNED: Six studies were included for meta-analysis. In total, 234 patients were in the RRH group and 174 patients were in the LRH group. RRH had significantly longer operative time (MD=14.23,95% CI:5.27~23.20, P=0.002),shorter hospital stay (MD= -1.10,95% CI:-1.43~0.76, P <0.00001),more dissected pelvic lymph nodes(MD=0.89,95%CI:0.18~1.60, P =0.01) and less blood loss(WMD = -27.78,95%CI:-58.69 ~ -3.14, P=0.08, I2 = 80%) compared with LRH. No significant difference was observed between two groups regarding positive surgical margin (OR = 0.59, 95% CI 0.18~2.76, P=0.61), over complications (OR = 0.77, 95% CI, 0.46-1.28, P=0.31), one-year recurrence rate (OR = 0.19, 95% CI 0.03-1.15, P=0.13), one-year mortality rate (OR = 0.19, 95% CI 0.03-1.15, P=0.07) and disease-free survival at one year (OR = 1.92, 95% CI 0.32-11.50, P=0.48).
UNASSIGNED: RRH is an increasingly popular surgical method known for its high level of security and efficiency. It has many benefits in comparison to LRH, such as decreased blood loss, a higher quantity of dissected pelvic lymph nodes, and a shorter duration of hospitalization. Further multicenter, randomized controlled trials with extended follow-up durations are necessary to conclusively determine the safety and efficacy of RRH, as no significant differences were observed in terms of positive surgical margin, postoperative complications, 1-year recurrence, 1-year mortality, and 1-year disease-free survival.
UNASSIGNED: PROSPERO, identifier CRD42023446653.
■在四个数据库中进行了系统搜索(Medline,Embase,WebofScience,和CENTRAL)用于比较RRH和LRH在宫颈癌治疗中的应用的研究。搜索包括从数据库开始到2023年7月18日发表的文章。进行荟萃分析以评估几种手术结果,包括操作时间,估计失血量,住院时间,盆腔淋巴结,切缘阳性,总并发症,一年复发率,一年死亡率,和一年无病生存率。
■纳入6项研究进行荟萃分析。总的来说,RRH组234例,LRH组174例。RRH手术时间明显延长(MD=14.23,95%CI:5.27~23.20,P=0.002),住院时间较短(MD=-1.10,95%CI:-1.43~0.76,P<0.00001),与LRH相比,盆腔淋巴结清扫更多(MD=0.89,95CI:0.18〜1.60,P=0.01),失血更少(WMD=-27.78,95CI:-58.69〜-3.14,P=0.08,I2=80%)。两组切缘阳性差异无统计学意义(OR=0.59,95%CI0.18~2.76,P=0.61)。超过并发症(OR=0.77,95%CI,0.46-1.28,P=0.31),1年复发率(OR=0.19,95%CI0.03-1.15,P=0.13),1年死亡率(OR=0.19,95%CI0.03-1.15,P=0.07)和1年无病生存率(OR=1.92,95%CI0.32-11.50,P=0.48)。
■RRH是一种日益流行的手术方法,以其高水平的安全性和效率而闻名。与LRH相比,它有很多好处,比如减少失血,解剖的盆腔淋巴结数量较多,和更短的住院时间。进一步多中心,延长随访时间的随机对照试验对于最终确定RRH的安全性和有效性是必要的,因为在阳性手术切缘方面没有观察到显著差异,术后并发症,1年复发,1年死亡率,和1年无病生存期。
■PROSPERO,标识符CRD42023446653。