旨在按治疗类型分层检查微创手术 (MIS) 和传统腹部手术治疗上皮性卵巢癌 (EOC) 的有效性和安全性。日本妇科肿瘤学会专家小组进行了系统评价和荟萃分析卵巢癌委员会。日本医学图书馆协会于2023年11月11日使用关键词“上皮性卵巢癌”、“微创手术”、“腹腔镜”、“机器人”检索了PubMed/MEDLINE、Cochrane Database、Ichushi等多个学术数据库。 - 协助”。两位作者独立评估了描述 MIS 治疗 EOC 与传统腹部手术对比的文章。主要结局是生存率和围手术期不良事件。筛选 1114 项研究后，确定了 35 篇文章，包括早期 EOC EOC 的一期手术 (PSS)（n = 20）和间隔减瘤手术后的新辅助化疗 (NACT-IDS； n = 10) 和针对晚期 EOC 的前期初次减瘤手术 (PDS; n = 5)。这些研究包括 29,888 名患者（7661 名接受 MIS 治疗，22,227 名接受腹部手术）。接受 MIS 和腹部手术的患者总体生存率相似（PSS：优势比 [OR] 1.02，95% 置信区间 [CI] 0.75-1.37；NACT-IDS：OR 0.93，95%CI 0.25-3.44；PDS：OR 0.66， 95%CI 0.36-1.22，所有 P > 0.05）。 MIS 的围手术期并发症发生率与腹部手术相当（术中和术后，所有治疗类型 P ≥ 0.05）。然而，早期EOC的淋巴结清扫率（PSS：OR 0.49，95%CI0.26-0.91）和晚期EOC的多脏器切除率（NACT-IDS：OR 0.27 95%CI 0.16-0.44和PDS） ：OR 0.27，95%CI 0.16-0.44) MIS 低于腹部手术（均 P < 0.05）。与腹部手术相比，MIS 不会对 EOC 患者的生存和围手术期并发症产生负面影响。虽然 MIS 是一种可行的选择，但不同的病例选择和手术程序表明存在潜在偏差，需要进一步验证研究。版权所有 © 2024 Elsevier Inc. 保留所有权利。

To examine the efficacy and safety of minimally invasive surgery (MIS) and conventional abdominal surgery for epithelial ovarian cancer (EOC), stratified by treatment type.A systematic review and meta-analysis were conducted by an Expert Panel of the Japan Society of Gynecologic Oncology Ovarian Cancer Committee. Several academic databases, including PubMed/MEDLINE, Cochrane Database, and Ichushi were searched by the Japan Medical Library Association on November 11, 2023, using the keywords "epithelial ovarian cancer", "minimally invasive surgery", "laparoscopic", and "robot-assisted". Articles describing MIS treatment for EOC compared with conventional abdominal surgery were independently assessed by two authors. The primary outcomes were survival and perioperative adverse events.After screening 1114 studies, 35 articles were identified, including primary staging surgery (PSS) for early-stage EOC EOC (n = 20) and neoadjuvant chemotherapy following interval debulking surgery (NACT-IDS; n = 10) and upfront primary debulking surgery (PDS; n = 5) for advanced-stage EOC. These studies included 29,888 patients (7661 undergoing MIS and 22,227 undergoing abdominal surgery). Patients receiving MIS and abdominal surgery had similar overall survival (PSS: odds ratio [OR] 1.02, 95% confidence interval [CI] 0.75-1.37; NACT-IDS: OR 0.93, 95%CI 0.25-3.44 and PDS: OR 0.66, 95%CI 0.36-1.22, all P > 0.05). MIS showed perioperative complication rates comparable to those of abdominal surgery (intraoperative and postoperative, all treatment types P ≥ 0.05). However, the rate of lymph node dissection in early-stage EOC (PSS: OR 0.49, 95%CI0.26-0.91) and multivisceral resections in advanced-stage EOC (NACT-IDS: OR 0.27 95%CI 0.16-0.44 and PDS: OR 0.27, 95%CI 0.16-0.44) was lower in MIS than in abdominal surgery (all P < 0.05).MIS did not negatively impact the survival and perioperative complications of patients with EOC compared to abdominal surgery. While MIS is a viable option, varied case selection and surgical procedures suggest potential bias, requiring further validation studies.Copyright © 2024 Elsevier Inc. All rights reserved.