复杂上泌尿道疾病的混合内镜机器人方法:系统性审查和单臂元分析
Rafał B Drobot1,2, Filip N Pietrzak3, Artur A Antoniewicz4,3
1Urology Department, Institute of Medical Sciences, Faculty of Medicine, Collegium Medicum, Cardinal Stefan Wyszyński University in Warsaw, Bursztynowa 2, 04-749, Warsaw, Poland. r.drobot@uksw.edu.pl.
Journal of robotic surgery
|October 1, 2025
概括
混合内镜 - 机器人方法 (HERA) 对复杂的上部泌尿道疾病 (CUUTD) 是有前途的,可以实现高无结石率和阻塞分辨率. 然而,证据质量较低,需要进一步研究.
科学领域:
- 泌尿器科 泌尿器科 泌尿器科 泌尿器科
- 最少侵入性的手术
- 机器人手术 机器人手术
背景情况:
- 复杂的上部泌尿道疾病 (CUUTD) 存在重大临床挑战.
- 关于混合内镜机器人方法 (HERA) 对CUUTD的疗效的证据有限.
研究的目的:
- 评估HERA在成人和儿童群体中对CUUTD的疗效,安全性和结果.
- 通过系统审查和元分析来综合现有数据.
主要方法:
- 一个符合PRISMA的系统审查和单臂元分析.
- 在PubMed,Scopus和Web of Science数据库中搜索相关研究.
- 包括14项具有低偏差风险的回顾性研究 (2005-2023年).
主要成果:
- 聚合无石头率 (SFR) 为90.3%,在成年人 (100%) 中高于儿科 (81.8%).
- 阻塞的解决率为100%,手术后并发症为11.6% (Clavien-Dindo II-IIIa).
- 重复手术率为9.6%,平均手术时间为185.2分钟,平均住院时间为3.5天.
结论:
- 在选定的患者和经验丰富的中心中,HERA可以在可接受的发病率下实现高SFR和阻塞分辨率.
- 证据的整体强度较低,存在大量的异质性和检测到的出版偏差.
- 需要进行前性比较研究来证实这些初步的,产生假设的发现.
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