■随着机器人手术的快速发展,尤其是腹部手术,机器人胰腺手术(RPS)已在世界各地得到越来越多的应用。然而,关于其应用的循证指南,安全,仍然缺乏功效。为了获得有力的证据和全面的临床实践,这项研究旨在制定RPS使用的国际指南。
■世界卫生组织(WHO)指南制定手册,等级网格法,德尔福投票,和AGREE-II仪器用于建立指南指导小组,指导发展小组,和指导方针秘书小组,制定19个临床问题,制定建议,并起草指导方针。在2020年4月12日、2021年11月30日和2022年01月25日举行了三次在线会议,对建议进行投票,并从所有相关专家那里获得建议和建议。所有专注于美国微创手术的专家,欧洲和大洋洲为这一共识准则做出了巨大贡献。
■在纳入176项研究的系统文献综述后,通过专家评估和对证据质量和可信度的综合判断,解决了19个问题,提出了14个建议。
■国际RPS指南可以指导外科医生的当前实践,病人,医学社会,医院管理员,和相关的社会社区。与开腹和腹腔镜手术相比,需要进一步的随机试验来确定RPS的附加值。
UNASSIGNED: With the rapid development of robotic surgery, especially for the abdominal surgery, robotic pancreatic surgery (RPS) has been applied increasingly around the world. However, evidence-based
guidelines regarding its application, safety, and efficacy are still lacking. To harvest robust evidence and comprehensive clinical practice, this study aims to develop international guidelines on the use of RPS.
UNASSIGNED: World Health Organization (WHO) Handbook for Guideline Development, GRADE Grid method, Delphi vote, and the AGREE-II instrument were used to establish the Guideline Steering Group,
Guideline Development Group, and
Guideline Secretary Group, formulate 19 clinical questions, develop the recommendations, and draft the
guidelines. Three online meetings were held on 04/12/2020, 30/11/2021, and 25/01/2022 to vote on the recommendations and get advice and suggestions from all involved experts. All the experts focusing on minimally invasive surgery from America, Europe and Oceania made great contributions to this
consensus guideline.
UNASSIGNED: After a systematic literature review 176 studies were included, 19 questions were addressed and 14 recommendations were developed through the expert assessment and comprehensive judgment of the quality and credibility of the evidence.
UNASSIGNED: The international RPS guidelines can guide current practice for surgeons, patients, medical societies, hospital administrators, and related social communities. Further randomized trials are required to determine the added value of RPS as compared to open and laparoscopic surgery.