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目的系统评价机器人辅助胃底折叠术与腹腔镜下行胃底折叠术治疗小儿胃食管反流病的临床效果。方法计算机检索PubMed、Embase、Cochrane Library等数据库,同时根据以上检索所得文献的参考文献进行扩大检索。采用RevMan5.3统计软件进行Meta分析。结果共纳入4项符合标准的研究,共计194例病人。结果显示,机器人辅助与腹腔镜下行胃底折叠术相比,在中转开腹(OR=0.47,95%CI为0.13~1.69,P=0.25)、术后并发症(OR=1.19,95%CI为0.47~3.03,P=0.72)及术后住院时间(MD=-0.04,95%CI为-2.28~2.75,P=0.98)上差异均无统计学意义。结论机器人辅助与腹腔镜下行胃底折叠术相比,其安全性及有效性无明显优势,但其治疗费用更高且手术时间更长。
Objective To systematically evaluate the clinical effects of robot assisted fundoplication and laparoscopic fundoplication on children with gastroesophageal reflux disease. Methods The databases of PubMed, Embase and Cochrane Library were searched by computer, and the search was expanded based on the references of the above retrieved documents. RevMan5.3 statistical software for meta-analysis. Results A total of 4 eligible studies were included, for a total of 194 patients. The results showed that compared with laparoscopic fundoplasmysis, robotic assist was significantly associated with open surgery (OR = 0.47, 95% CI 0.13-1.69, P = 0.25), postoperative complications (OR = 1.19, 95% CI 0.47 ~ 3.03, P = 0.72) and postoperative hospital stay (MD = -0.04, 95% CI -2.28 ~ 2.75, P = 0.98), there was no significant difference. Conclusion Compared with laparoscopic gastric fundoplication, there is no obvious advantage in safety and effectiveness of robot assisted therapy, but its cost is higher and the operation time is longer.