PDF(Pubmed)
Abstract：
Inguinal hernia repair is a common surgical intervention. Advancements in minimally invasive techniques, specifically laparoscopic (LR) and robot-assisted (RR) approaches, have reshaped the landscape of surgical options. This meta-analysis aimed to systematically assess and compare the effectiveness and safety of laparoscopic and robot-assisted inguinal hernia repair through a comprehensive review of the literature. A systematic search of databases was conducted to identify relevant studies published up to November 30, 2023. Fifteen studies, encompassing a total of 64,568 participants, met the inclusion criteria. Pooled estimates for key outcomes, including duration of operation, overall complications, and surgical site infection (SSI), were calculated using random-effects models. This meta-analysis revealed a statistically significant difference in the duration of surgery, favoring laparoscopic repair over robot-assisted techniques (mean difference: 26.85 minutes, 95% CI (1.16, 52.54)). Overall complications did not significantly differ between the two approaches (odds ratio: 1.54, 95% CI (0.83, 2.85)). However, a significantly greater risk of SSI was identified for robot-assisted procedures (odds ratio: 3.32, 95% CI (2.63, 4.19)). This meta-analysis provides insights into the comparative effectiveness of laparoscopic and robot-assisted inguinal hernia repair. While laparoscopy has shorter operative times and comparable overall complication rates, the increased risk of SSI during robot-assisted procedures necessitates careful consideration in clinical decision-making. Surgeons and healthcare providers should weigh these findings according to patient characteristics, emphasizing a personalized approach to surgical decision-making. The evolving landscape of inguinal hernia repair warrants ongoing research to refine techniques and optimize outcomes for the benefit of patients undergoing these procedures.
摘要：
腹股沟疝修补术是一种常见的外科手术。微创技术的进步，特别是腹腔镜(LR)和机器人辅助(RR)方法，重塑了手术选择的格局。这项荟萃分析旨在通过对文献的全面回顾，系统地评估和比较腹腔镜和机器人辅助腹股沟疝修补术的有效性和安全性。对数据库进行了系统搜索，以确定截至2023年11月30日发表的相关研究。15项研究,共有64,568名参与者，符合纳入标准。对关键成果的汇总估计，包括操作持续时间，整体并发症,和手术部位感染（SSI），使用随机效应模型计算。这项荟萃分析揭示了手术持续时间的统计学差异，与机器人辅助技术相比，更喜欢腹腔镜修复(平均差：26.85分钟，95%CI（1.16，52.54））。两种方法的总体并发症没有显着差异（比值比：1.54，95％CI（0.83，2.85））。然而,机器人辅助手术的SSI风险显著增加(比值比:3.32,95%CI(2.63,4.19)).这项荟萃分析提供了对腹腔镜和机器人辅助腹股沟疝修补术的比较有效性的见解。虽然腹腔镜检查的手术时间较短，总体并发症发生率相当，在机器人辅助手术期间,SSI的风险增加需要在临床决策中仔细考虑.外科医生和医疗保健提供者应根据患者特征权衡这些发现，强调个性化的手术决策方法。腹股沟疝修补术的不断发展的景观值得进行研究，以改进技术并优化结果，以使接受这些手术的患者受益。
