更新系統評價和網路數據分析
比較開放、腹腔鏡和機器人輔助骶骨固定術盆腔器官脫垂
張嘉論1,2、陳春華4、楊緒棣1,2、張尚仁3、蔡耀州1,2
1佛教慈濟醫療財團法人台北慈濟醫院泌尿科，2花蓮慈濟大學醫學院，3國立臺灣大學醫學院附設醫院泌尿科，4台北市立萬芳醫院神經內科
An Updated Systematic Review And Network Meta‑Analysis Comparing
Open, Laparoscopic And Robotic‑Assisted Sacrocolpopexy For Managing
Pelvic Organ Prolapse
Chia‑Lun Chang1,2, Chun‑Hua Chen4, Stephen Shei‑Dei Yang1,2, Shang‑Jen Chang3, Yao-Chou Tsai1,2
1Division of Urology, Taipei Tzu Chi Hospital, Tzu Chi Medical Foundation, New Taipei City 231, Taiwan,2School of Medicine, Tzu Chi University, Hualien City 970, Taiwan,3Department of Urology,National Taiwan University Hospital,Taipei,Taiwan,4Department of Neurology, Taipei Municipal Wanfang Hospital, Taipei, Taiwan
Purpose: Abdominal sacrocolpopexy is considered as the gold standard treatment for pelvic organ prolapse. Sacrocolpopexy can be performed using open (OSC), laparoscopic (LSC), and robotic assisted (RSC) approaches. The aim of this study is to compare the outcomes between these three approaches for managing pelvic organ prolapse by conducting a systematic review and network meta-analysis.
Materials and Methods: A systematic search was performed in different databases from their earliest records to April 2021 with no restriction on languages. Only randomized controlled trials that compared the outcomes between OSC, LSC and RSC were included in this study.
Results: A total of 6 studies with 486 participants were included in this study. Operative time was significantly shorter in OSC than in RSC and LSC. The probability rank showed less estimated blood loss in RSC and lowest overall postoperative complications in LSC. Probability scores also showed best anatomical outcomes for postoperative points C and Bp in RSC and for point Ba in LSC.
Conclusion: Despite significantly longer operative time, RSC and LSC may provide better anatomical outcomes, less estimated blood loss, and less overall postoperative complications than OSC. However, this study did not find significant differences between RSC and LSC in efficacy and safety.