当前位置： SCI文献检索 > INTERNATIONAL JOURNAL OF COLORECTAL DISEASE期刊下所有文献 > Meta-analysis and trial sequential analysis of robotic versus laparoscopic total mesorectal excision in management of rectal cancer.

Meta-analysis and trial sequential analysis of robotic versus laparoscopic total mesorectal excision in management of rectal cancer.

Abstract：

BACKGROUND:We aimed to evaluate comparative outcomes of robotic and laparoscopic total mesorectal excision (TME) in patients with rectal cancer. METHODS:We systematically searched electronic data sources with application of combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators, and limits. Perioperative clinical and short-term oncological outcomes were evaluated. Trial Sequential Analysis of the outcomes was conducted. RESULTS:Nine randomised-controlled trials reporting 1463 patients evaluating outcomes of robotic TME (n = 728) and laparoscopic TME (n = 735) were included. Although the robotic approach was associated with significantly longer operative time (MD 31.64, P = 0.002), it was associated with significantly longer DRM (MD 0.8, P = 0.004) and shorter time to soft diet (MD - 0.50, P = 0.03) compared to the laparoscopic approach. Moreover, there was no significant difference in intraoperative (RR 1.07, P = 0.76)) and postoperative (RR 0.97, P = 0.81) complications, anastomotic leak (RR 0.93, P = 0.69), conversion to open rate (RR 0.46, P = 0.05), blood loss (MD 19.65, P = 0.74), time to first flatus (MD - 0.30, P = 0.37), LARS (RR 0.83, P = 0.41), ileus (RR 0.72, P = 0.39), positive CRM (RR 0.82, P = 0.49), PRM (MD - 0.5, P = 0.55), number of harvested lymph nodes (MD 0.33, P = 0.58), or length of stay (MD - 0.60, P = 0.12) between two groups. The Trial Sequential Analysis demonstrated that the risk of type 1 and type 2 errors was minimal in most outcomes. CONCLUSIONS:Moderate-quality evidence suggested that robotic and laparoscopic TME may be comparable in terms of clinical and short-term oncological profile but the robotic approach may be associated with longer procedure time. Future high-quality randomised studies are encouraged to compare the functional, long-term oncological, and cost-effectiveness outcomes of both approaches.

journal_name

Int J Colorectal Dis

journal_title

International journal of colorectal disease

authors

Eltair M,Hajibandeh S,Hajibandeh S,Nuno A,Abdullah KH,Alkaili-Alyamani A,Aslam MI,Sinha A,Agarwal T

doi

10.1007/s00384-020-03655-2

subject

Has Abstract

pub_date

2020-08-01 00:00:00

pages

1423-1438

issue

eissn

0179-1958

issn

1432-1262

pii

10.1007/s00384-020-03655-2

journal_volume

pub_type

杂志文章,评审

在线工具

Meta-analysis and trial sequential analysis of robotic versus laparoscopic total mesorectal excision in management of rectal cancer.