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机器人子宫切除术后同日出院的决定因素和安全性:系统性审查和元分析

Kyrillos Mahrous Gerges¹, Gregg Nelson², Fernando Heredia³

¹Faculty of Medicine, Sohag University, Sohag, Egypt.

Journal of minimally invasive gynecology

|February 13, 2026

概括

机器人子宫切除术 (RH) 后的当日出院对于某些患者是安全的. 诸如年龄,并发症和手术复杂性等因素影响出院时间,在当天出院和术后入院组之间观察到类似的安全结果.

科学领域:

妇科瘤学妇科瘤学
手术结果研究研究.
医疗保健服务研究医疗服务研究

背景情况:

机器人子宫切除术 (RH) 越来越多地用于妇科手术.
在RH后出院的时间是影响患者康复和医疗保健资源利用的关键因素.
了解影响当日出院 (SDD) 的因素对于优化患者选择和护理途径至关重要.

研究的目的:

系统地审查与RH后放电时间相关的术后因素.
评估同日出院 (SDD) 的安全性,与在RH后的术后入院相比.

主要方法:

在主要数据库 (PubMed,Embase,Scopus,Cochrane,Web of Science) 进行了全面的文献搜索,截至2025年5月.
包括对照SDD与手术后入院的队列研究在接受RH的妇女中.
评估的结果包括SDD的决定因素和安全指标,如再入院和重新手术;偏差风险使用纽卡斯尔-太华尺度进行评估.

主要成果:

分析了10项涉及3200名患者 (1801名SDD,1399名入院患者) 的研究.
与较低的SDD几率相关的术前因素包括晚年 (>75),肥胖,较高的ASA得分,特定的并发症,先前的腹腔切除术,抗凝剂,先进的FIGO阶段,高瘤等级和贫血.
降低SDD可能性的内科手术因素包括并发手术,迷你拉巴切除术,开放转换,更长的手术时间,延迟开始时间和显著的血液损失 (>200毫升). 安全结果在各组之间没有显著差异.

结论:

对于精心挑选的患者,特别是年轻的,非肥胖的个人,具有较少的并发症和较少复杂的程序,RH后的当日出院是安全的和可行的.
确定的因素可以作为潜在风险指标,但未经调整的数据限制了最终的因果结论.
需要进一步的前性研究和RCT来确认关联,并为RH开发基于证据的SDD协议.

关键词:

停留的时间长度.最少侵入性的手术手术后的入院情况机器人子宫切除术是一种机器人子宫切除术.同一天的排放.

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