Effects of laparoscopic vs robotic-assisted mesorectal excision for rectal cancer

An update systematic review and meta-analysis of randomized controlled trials

研究成果: 雜誌貢獻回顧型文獻

4 引文 (Scopus)

摘要

Background: Controversy still surrounds clinical benefits of robotic-assisted (RS) over laparoscopic surgery (LS) despite its popularity in clinical use in terms of outcomes and complication rates. The study aims to systematically review and provide the evidence concerning the risk of conversion to open laparotomy and oncological outcomes of LS vs RS rectal cancer surgery. Methods: The Cochrane Library (including the Cochrane Central Register of Controlled Trials), EMBASE, PubMed, SCOPUS, and Web of Science were searched for randomized controlled trials (RCTs) comparing LS and RS. Results: Eight RCTs including 1305 patients were identified. Pooled conversion rate was reported in 49 (11.89%) of 412 patients who underwent LS and in 23 (5.72%) of 402 patients who underwent RS (95% CI, 1.357 to 3.613; P =.001). However, shorter operative time was noted in LS group than RS group (95% CI, −43.106 to −3.876; P =.019). No significant difference in other outcomes was observed. Finally, in further analysis, the mean age in trial-level was found to be positively associated with operative time (point estimate = 2.598; 95% CI, 1.584 to 3.612; P <.001) and negatively with length of hospital stay. Conclusions: Robot-assisted surgery in rectal cancer showed lower conversion rate in comparison with that of laparoscopic surgery. Secondly, the laparoscopic surgery has shorter operative time compared with robot-assisted approach. The results also showed similar pathological outcomes between these two modalities. Future studies are needed to clarify the relationship between mean age and outcomes of surgery.
原文英語
頁(從 - 到)657-666
頁數10
期刊Asian Journal of Surgery
42
發行號6
DOIs
出版狀態已發佈 - 六月 1 2019

指紋

Robotics
Rectal Neoplasms
Laparoscopy
Meta-Analysis
Randomized Controlled Trials
Operative Time
Length of Stay
PubMed
Laparotomy
Libraries

ASJC Scopus subject areas

  • Surgery

引用此文

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title = "Effects of laparoscopic vs robotic-assisted mesorectal excision for rectal cancer: An update systematic review and meta-analysis of randomized controlled trials",
abstract = "Background: Controversy still surrounds clinical benefits of robotic-assisted (RS) over laparoscopic surgery (LS) despite its popularity in clinical use in terms of outcomes and complication rates. The study aims to systematically review and provide the evidence concerning the risk of conversion to open laparotomy and oncological outcomes of LS vs RS rectal cancer surgery. Methods: The Cochrane Library (including the Cochrane Central Register of Controlled Trials), EMBASE, PubMed, SCOPUS, and Web of Science were searched for randomized controlled trials (RCTs) comparing LS and RS. Results: Eight RCTs including 1305 patients were identified. Pooled conversion rate was reported in 49 (11.89{\%}) of 412 patients who underwent LS and in 23 (5.72{\%}) of 402 patients who underwent RS (95{\%} CI, 1.357 to 3.613; P =.001). However, shorter operative time was noted in LS group than RS group (95{\%} CI, −43.106 to −3.876; P =.019). No significant difference in other outcomes was observed. Finally, in further analysis, the mean age in trial-level was found to be positively associated with operative time (point estimate = 2.598; 95{\%} CI, 1.584 to 3.612; P <.001) and negatively with length of hospital stay. Conclusions: Robot-assisted surgery in rectal cancer showed lower conversion rate in comparison with that of laparoscopic surgery. Secondly, the laparoscopic surgery has shorter operative time compared with robot-assisted approach. The results also showed similar pathological outcomes between these two modalities. Future studies are needed to clarify the relationship between mean age and outcomes of surgery.",
keywords = "Laparoscopic surgery, Meta-analysis, Rectal cancer, Robotic surgery",
author = "Huang, {Yan Jiun} and Kang, {Yi No} and Huang, {Yu Min} and Wu, {Alexander TH} and Weu Wang and Wei, {Po Li}",
year = "2019",
month = "6",
day = "1",
doi = "10.1016/j.asjsur.2018.11.007",
language = "English",
volume = "42",
pages = "657--666",
journal = "Asian Journal of Surgery",
issn = "1015-9584",
publisher = "Elsevier Taiwan LLC",
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TY - JOUR

T1 - Effects of laparoscopic vs robotic-assisted mesorectal excision for rectal cancer

T2 - An update systematic review and meta-analysis of randomized controlled trials

AU - Huang, Yan Jiun

AU - Kang, Yi No

AU - Huang, Yu Min

AU - Wu, Alexander TH

AU - Wang, Weu

AU - Wei, Po Li

PY - 2019/6/1

Y1 - 2019/6/1

N2 - Background: Controversy still surrounds clinical benefits of robotic-assisted (RS) over laparoscopic surgery (LS) despite its popularity in clinical use in terms of outcomes and complication rates. The study aims to systematically review and provide the evidence concerning the risk of conversion to open laparotomy and oncological outcomes of LS vs RS rectal cancer surgery. Methods: The Cochrane Library (including the Cochrane Central Register of Controlled Trials), EMBASE, PubMed, SCOPUS, and Web of Science were searched for randomized controlled trials (RCTs) comparing LS and RS. Results: Eight RCTs including 1305 patients were identified. Pooled conversion rate was reported in 49 (11.89%) of 412 patients who underwent LS and in 23 (5.72%) of 402 patients who underwent RS (95% CI, 1.357 to 3.613; P =.001). However, shorter operative time was noted in LS group than RS group (95% CI, −43.106 to −3.876; P =.019). No significant difference in other outcomes was observed. Finally, in further analysis, the mean age in trial-level was found to be positively associated with operative time (point estimate = 2.598; 95% CI, 1.584 to 3.612; P <.001) and negatively with length of hospital stay. Conclusions: Robot-assisted surgery in rectal cancer showed lower conversion rate in comparison with that of laparoscopic surgery. Secondly, the laparoscopic surgery has shorter operative time compared with robot-assisted approach. The results also showed similar pathological outcomes between these two modalities. Future studies are needed to clarify the relationship between mean age and outcomes of surgery.

AB - Background: Controversy still surrounds clinical benefits of robotic-assisted (RS) over laparoscopic surgery (LS) despite its popularity in clinical use in terms of outcomes and complication rates. The study aims to systematically review and provide the evidence concerning the risk of conversion to open laparotomy and oncological outcomes of LS vs RS rectal cancer surgery. Methods: The Cochrane Library (including the Cochrane Central Register of Controlled Trials), EMBASE, PubMed, SCOPUS, and Web of Science were searched for randomized controlled trials (RCTs) comparing LS and RS. Results: Eight RCTs including 1305 patients were identified. Pooled conversion rate was reported in 49 (11.89%) of 412 patients who underwent LS and in 23 (5.72%) of 402 patients who underwent RS (95% CI, 1.357 to 3.613; P =.001). However, shorter operative time was noted in LS group than RS group (95% CI, −43.106 to −3.876; P =.019). No significant difference in other outcomes was observed. Finally, in further analysis, the mean age in trial-level was found to be positively associated with operative time (point estimate = 2.598; 95% CI, 1.584 to 3.612; P <.001) and negatively with length of hospital stay. Conclusions: Robot-assisted surgery in rectal cancer showed lower conversion rate in comparison with that of laparoscopic surgery. Secondly, the laparoscopic surgery has shorter operative time compared with robot-assisted approach. The results also showed similar pathological outcomes between these two modalities. Future studies are needed to clarify the relationship between mean age and outcomes of surgery.

KW - Laparoscopic surgery

KW - Meta-analysis

KW - Rectal cancer

KW - Robotic surgery

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U2 - 10.1016/j.asjsur.2018.11.007

DO - 10.1016/j.asjsur.2018.11.007

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JO - Asian Journal of Surgery

JF - Asian Journal of Surgery

SN - 1015-9584

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