机器人 DIEP 皮瓣手术的演变与适应性:系统回顾

IF 1 4区 医学 Q3 SURGERY
Suat Morkuzu, K Can Bayezid, Berk B Ozmen, Seyma Fatima Eren, Souha Farhat, Alexandra L McLennan, Andrew J James, Dariush Nikkhah, Saïd C Azoury, Risal S Djohan, Sarah N Bishop, Graham S Schwarz
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引用次数: 0

摘要

背景:将机器人技术整合到外科手术中,因其有望提高各种临床效果而备受关注。机器人下腹穿孔器(DIEP)皮瓣采集已成为自体乳房重建的一种新方法。本系统性综述旨在全面概述目前机器人DIEP皮瓣手术的技术、效果和并发症:方法:根据PRISMA 2020指南,在2000年至2023年期间的PubMed、Embase、Google Scholar和Web of Science等数据库中进行了系统性文献检索。对探讨机器人DIEP皮瓣采集用于乳房重建的文章进行了评估,以比较手术技术、临床效果和并发症。采用ROBINS-I和纽卡斯尔-渥太华量表对偏倚风险进行评估:结果:共纳入 14 项研究,涉及 108 名患者。三项研究采用了完全腹膜外(TEP)技术,而 11 项研究采用了经腹腹膜前(TAPP)方法。术前规划采用了计算机断层扫描血管成像和磁共振血管成像。机器人手术的平均时间为64分钟,TAPP的总手术时间平均为574分钟,TEP的总手术时间平均为497分钟。平均住院时间为5天,平均筋膜切口长度为3厘米。总体并发症发生率为14.9%,与传统DIEP皮瓣手术相比无明显差异:结论:机器人DIEP皮瓣采集术是一种很有前景的技术,可减少术后疼痛,限制腹部供体部位的发病率。潜在的局限性包括手术时间较长、住院时间不固定以及费用增加。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Evolution and Adaptations of Robotic DIEP Flap Surgery: A Systematic Review.

Background: The integration of robotic technology into surgical procedures has gained considerable attention for its promise to enhance a variety of clinical outcomes. Robotic deep inferior epigastric perforator (DIEP) flap harvest has emerged as a novel approach for autologous breast reconstruction. This systematic review aims to provide a comprehensive overview of the current techniques, outcomes, and complications of robotic DIEP flap surgery.

Methods: A systematic literature search was conducted after PRISMA 2020 guidelines across databases including PubMed, Embase, Google Scholar, and Web of Science from 2000 to 2023. Articles exploring robotic DIEP flap harvest for breast reconstruction were assessed to compare operative techniques, clinical outcomes, and complications. The risk of bias was evaluated using ROBINS-I and the Newcastle-Ottawa scale.

Results: Fourteen studies involving 108 patients were included. Three studies used a totally extraperitoneal (TEP) technique, whereas 11 studies used a transabdominal preperitoneal (TAPP) approach. Preoperative planning utilized computed tomography angiography and magnetic resonance angiography imaging. The mean robotic operative time was 64 minutes, with total operative times averaging 574 minutes for TAPP and 497 minutes for TEP. The mean length of stay was 5 days, and the mean fascial incision length was 3 cm. Overall complication rate was 14.9%, with no significant difference compared with conventional DIEP flap procedures.

Conclusion: Robotic DIEP flap harvest is a promising technique that may reduce postoperative pain and limiting abdominal donor site morbidity. Potential limitations include longer operative times, variable hospital stays, and increased costs.

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来源期刊
CiteScore
1.70
自引率
11.10%
发文量
968
审稿时长
1.5 months
期刊介绍: ​The Journal of Craniofacial Surgery serves as a forum of communication for all those involved in craniofacial surgery, maxillofacial surgery and pediatric plastic surgery. Coverage ranges from practical aspects of craniofacial surgery to the basic science that underlies surgical practice. The journal publishes original articles, scientific reviews, editorials and invited commentary, abstracts and selected articles from international journals, and occasional international bibliographies in craniofacial surgery.
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