■腹膜后淋巴结清扫术(RPLND)是治疗睾丸肿瘤的有效方法。近年来,随着机器人技术的发展,许多通过标准腹腔镜进行的泌尿外科手术已被机器人取代。我们的目的是比较机器人腹膜后淋巴结清扫术(R-RPLND)与非机器人腹膜后淋巴结清扫术(NR-RPLND)在睾丸癌中的安全性和有效性。
■已发布,Embase,Scopus,科克伦图书馆,和WebofScience数据库在2023年4月之前搜索有关机器人手术治疗睾丸生殖细胞肿瘤的文献。使用ReviewManager5.3进行统计学和敏感性分析。进行Meta分析以计算平均差异(MD),比值比(OR),和95%置信区间(CI)效应指标。
■这项研究最终纳入了3875名患者的8项研究,453采用R-RPLND,3422采用开放式腹膜后淋巴结清扫术(O-RPLND)/腹腔镜腹膜后淋巴结清扫术(L-RPLND)。结果显示R-RPLND具有较低的术中失血率(MD=-436.39;95%CI-707.60至-165.19;P=0.002),输血(OR=0.06;95%CI0.01~0.26;P=0.0001),术后总并发症发生率(OR=0.39;95%CI0.21~0.70;P=0.002),和住院时间(MD=-3.74;95%CI-4.69至-2.78;P<0.00001)。此外,两组在围手术期和肿瘤预后方面的总手术时间没有统计学差异,术后并发症的发生率≥III级,射精率异常,淋巴结产量,术后复发率。
■R-RPLND和O-RPLND/L-RPLND为睾丸癌提供了安全有效的腹膜后淋巴结清扫术。R-RPLND患者术中出血较少,住院时间较短,术后并发症少,更快的恢复。它应该被认为是O-RPLND/L-RPLND的可行替代品。
■https://www.crd.约克。AC.英国/PROSPERO,标识符CRD42023411696。
UNASSIGNED: Retroperitoneal lymph node dissection (RPLND) is an effective treatment for testicular tumors. In recent years, with the development of robotics, many urological procedures performed via standard laparoscopy have been replaced by robots. Our objective was to compare the safety and efficacy of robotic retroperitoneal lymph node dissection (R-RPLND) versus Non-robotic retroperitoneal lymph node dissection (NR-RPLND) in testicular cancer.
UNASSIGNED: Pubmed, Embase, Scopus, Cochrane Library, and Web of Science databases were searched for literature on robotic surgery for testicular germ cell tumors up to April 2023. The statistical and sensitivity analyses were performed using Review Manager 5.3. Meta-analysis was performed to calculate mean difference (MD), odds ratio(OR), and 95% confidence interval (CI) effect indicators.
UNASSIGNED: Eight studies with 3875 patients were finally included in this study, 453 with R-RPLND and 3422 with open retroperitoneal lymph node dissection (O-RPLND)/laparoscopic retroperitoneal lymph node dissection (L-RPLND). The results showed that R-RPLND had lower rates of intraoperative blood loss (MD = -436.39; 95% CI -707.60 to -165.19; P = 0.002), transfusion (OR = 0.06; 95% CI 0.01 to 0.26; P = 0.0001), total postoperative complication rates (OR = 0.39; 95% CI 0.21 to 0.70; P = 0.002), and length of stay (MD=-3.74; 95% CI -4.69 to -2.78; P<0.00001). In addition, there were no statistical differences between the two groups regarding perioperative and oncological outcomes regarding total operative time, the incidence of postoperative complications grade≥III, abnormal ejaculation rate, lymph node yield, and postoperative recurrence rate.
UNASSIGNED: The R-RPLND and O-RPLND/L-RPLND provide safe and effective retroperitoneal lymph node dissection for testicular cancer. Patients with R-RPLND have less intraoperative bleeding, shorter hospitalization period, fewer postoperative complications, and faster recovery. It should be considered a viable alternative to O-RPLND/L-RPLND.
UNASSIGNED: https://www.crd.york.ac.uk/PROSPERO, identifier CRD42023411696.