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学科主题: 临床医学
题名:
Robotic Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer: a Meta-analysis of Eight Studies
作者: Xiong, Binghong1; Ma, Li2; Huang, Wei3; Zhao, Qikang1; Cheng, Yong4; Liu, Jingshan1
关键词: Rectal cancer ; Robotic ; Laparoscopy ; Total mesorectal excision ; Meta-analysis
刊名: JOURNAL OF GASTROINTESTINAL SURGERY
发表日期: 2015-03-01
DOI: 10.1007/s11605-014-2697-8
卷: 19, 期:3, 页:516-526
收录类别: SCI
文章类型: Article
WOS标题词: Science & Technology
类目[WOS]: Gastroenterology & Hepatology ; Surgery
研究领域[WOS]: Gastroenterology & Hepatology ; Surgery
关键词[WOS]: SHORT-TERM OUTCOMES ; RANDOMIZED CONTROLLED-TRIALS ; LOW ANTERIOR RESECTION ; MRC CLASICC TRIAL ; OPEN SURGERY ; SPHINCTER PRESERVATION ; ONCOLOGICAL SAFETY ; COLORECTAL-CANCER ; LOCAL RECURRENCE ; CLINICAL-TRIALS
英文摘要:

Robotic surgery has been used successfully in many branches of surgery, but there is little evidence in the literature on its use in rectal cancer (RC). We conducted this meta-analysis of randomized controlled trials (RCTs) and non-randomized controlled trials (NRCTs) to evaluate whether the safety and efficacy of robotic total mesorectal excision (RTME) in patients with RC are equivalent to those of laparoscopic TME (LTME).

Pubmed, Embase, Cochrane Library, Ovid, and Web of Science databases were searched. Studies clearly documenting a comparison of RTME with LTME for RC were selected. Operative and recovery outcomes, early postoperative morbidity, and oncological parameters were evaluated.

Eight studies were identified that included 1229 patients in total, 554 (45.08 %) in the RTME group and 675 (54.92 %) in the LTME group. Compared with LTME, RTME was associated with lower conversion rate (OR 0.23, 95 % CI [0.10, 0.52]; P = 0.0004), lower positive rate of circumferential resection margins (CRM) (2.74 % vs 5.78 %, OR 0.44, 95 % CI [0.20, 0.96], P = 0.04), and lesser incidence of erectile dysfunction (ED) (OR 0.09, 95 % CI [0.02, 0.41]; P = 0.002). Operation time, estimated blood loss, recovery outcome, postoperative morbidity and mortality, length of hospital stay, number of lymph nodes harvested, distal resection margin (DRM), proximal resection margin (PRM), and local recurrence had no significant differences between the two groups.

RTME is safe and feasible and may be an alternative treatment for RC. More international multicenter prospective large sample RCTs investigating the long-term oncological and functional outcomes are needed to determine the advantages of RTME over LTME in RC.

语种: 英语
WOS记录号: WOS:000349965000017
Citation statistics:
内容类型: 期刊论文
URI标识: http://ir.bjmu.edu.cn/handle/400002259/55482
Appears in Collections:北京大学首钢医院_普通外科_期刊论文

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作者单位: 1.Peking Univ, Shougang Hosp, Dept Gen Surg, Beijing 100144, Peoples R China
2.Third Hosp Mianyang, Dept Endocrinol, Mianyang 621000, Sichuan Provinc, Peoples R China
3.Ninth Peoples Hosp Chongqing City, Dept Gen Surg, Chongqing 400070, Peoples R China
4.Chongqing Med Univ, Affiliated Hosp 1, Dept Gen Surg, Chongqing 400016, Peoples R China

Recommended Citation:
Xiong, Binghong,Ma, Li,Huang, Wei,et al. Robotic Versus Laparoscopic Total Mesorectal Excision for Rectal Cancer: a Meta-analysis of Eight Studies[J]. JOURNAL OF GASTROINTESTINAL SURGERY,2015,19(3):516-526.
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