达芬奇机器人用于妇科手术的技术评价

摘要/Abstract

目的：快速评估达芬奇机器人系统（Da Vinci surgical system， DVSS）用于妇科手术的有效性、安全性和经济性，为决策者提供决策证据。方法：计算机检索 PubMed、EMbase、CNKI 等数据库。由 2 位评价者根据纳入与排除标准独立筛选文献、提取资料和评价质量后行描述性分析。结果：纳入 28 篇涉及妇科恶性肿瘤及部分良性妇科疾病手术文献，包括 22 篇系统评价/Meta 分析以及 6 篇经济性分析的研究。结果显示，达芬奇手术系统针对不同疾病的临床有效性和安全性结果有所差异。与传统开放手术方法相比，达芬奇手术系统虽延长了手术时间，但可缩短住院时间，并降低手术过程中的转换率、失血量和输血率；与传统腹腔镜手术相比，达芬奇手术系统可缩短住院时间，降低手术过程中的转换率、失血量和输血率。结论：达芬奇机器人手术系统在安全性和有效性上优于传统开放手术，但目前仍缺少证据证明达芬奇机器人手术系统比腹腔镜手术更具优越性，不过机器人手术在缩短住院时间方面可能会降低住院费用，这是机器人手术的潜在经济性。

Objective: To rapidly evaluate the effectiveness, safety and economical efficiency of Da Vinci surgical system (DVSS) in gynecological surgery, so to provide evidence for decision-makers. Methods: PubMed, EMbase, CNKI and other well-known databases were searched systematically. A descriptive analysis was made after independently screening literatures, extracting data and quality assessment by two reviewers according to the inclusion and exclusion criteria. Results: A total of 28 surgical literatures about gynecological malignant tumors and benign gynecological diseases were included. 22 of the 28 literatures are systematic reviews/Meta analysis and 6 studies are economic analyses. The results show that the clinical efficacy and safety of Da Vinci surgical system are various for different gynecological diseases. Compared with the traditional open surgery, even Da Vinci surgical system has a longer operation time, it can reduce blood loss, decrease conversion rate and blood transfusion rate. Compared with the traditional laparoscopic surgery, Da Vinci robot-assisted surgery has a shorter hospital stay, less blood loss, lower conversion rate and blood transfusion rate. Conclusion: Da Vinci surgical system is superior to traditional open surgery in safety and effectiveness, but no evidence proves that Da Vinci robot-assisted is superior to laparoscopic surgery. However, robotic surgery may reduce hospitalization costs in terms of shortening hospital stay, which can be the economical part in the future.

稿件信息

参考文献

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