文献类型：期刊文献

英文题名：The safety and effectiveness of robot-assisted versus laparoscopic TME in patients with rectal cancer A meta-analysis and systematic review

作者：Li, Xiaofei[1,2];Wang, Tao[3];Yao, Liang[4];Hu, Lidong[1,4];Jin, Penghui[5];Guo, Tiankang[1,2];Yang, Kehu[4,6]

第一作者：Li, Xiaofei

通信作者：Guo, TK[1];Yang, KH[2]

机构：[1]Gansu Prov Peoples HospitalGansu, Dept Gen Surg, Lanzhou, Gansu, Peoples R China;[2]Ningxia Med UniversityYinchuan, Sch Clin Med Sci, Yinchuan, Peoples R China;[3]Gansu Prov Peoples Hosp, Dept Anorectal Surg, Lanzhou, Gansu, Peoples R China;[4]Gansu Prov Peoples Hosp, Inst Clin Res & Evidence Based Med, Lanzhou, Gansu, Peoples R China;[5]Gansu Univ Tradit Chinese Med, Sch Clin Med Sci, Lanzhou, Gansu, Peoples R China;[6]Lanzhou Univ, Sch Basic Med Sci, Evidence Based Med Ctr, Lanzhou, Gansu, Peoples R China

第一机构：Gansu Prov Peoples HospitalGansu, Dept Gen Surg, Lanzhou, Gansu, Peoples R China

通信机构：[1]corresponding author), Peoples Hosp Gansu Prov, Lanzhou, Gansu, Peoples R China;[2]corresponding author), Lanzhou Univ, Lanzhou, Gansu, Peoples R China.

年份：2017

卷号：96

期号：29

外文期刊名：MEDICINE

收录：;WOS:【SCI-EXPANDED(收录号:WOS:000406477600063)】；

语种：英文

外文关键词：laparoscopy; meta-analysis; rectal cancer; robotic; total mesorectal excision

摘要：Background: The aim of this study was to assess the safety and effectiveness of robotic-assisted versus laparoscopic total mesorectal excision (TME) in patients with rectal cancer. Methods: We systematically searched PubMed, EMBASE, Cochrane library, Web of science, and Chinese Biomedical Literature Database up to July 2016 to identify case-controlled studies that compared robotic TME (RTME) with laparoscopic TME (LTME) for rectal cancer. GRADE was used to interpret the primary outcomes of this meta-analysis. Results: We included 17 case-control studies (3601 participants: 1726 underwent RTME and 1875 LTME for rectal cancer) that compared RTME with LTME for rectal cancer. We found no statistically significant differences between techniques for local recurrence [odds ratio (OR) = 0.68, P = .216] and overall survival at 3 years (OR = 0.71, P = 1.140), complications (OR = 1.02, P = .883), positive circumferential resection margin (PCRM) (OR = 0.80, P = .256), the first passing flatus [weighted mean difference (WMD) = -0.11, P = .130], reoperation (OR = 0.66, P = .080), estimated blood loss (EBL) (WMD = -12.45, P = .500), and length of stay in hospital (LOS) (WMD = -0.69, P = .089). Compared with LTME, RTME was associated with lower rate of conversion (OR = 0.35, P < .001), urinary retention (OR = 0.41, P = .025), and longer operative time (WMD = 57.43, P < .001). The overall quality of evidence was poor in all outcomes. Conclusion: RTME in patients with rectal cancer was associated with a lower rate of conversion and less incidence of urinary retention. Generally, operative time in RTME was significantly longer than in LTME. The long-term oncological and function outcomes of RTME seem to be equivalent with LTME. Therefore, analysis of current studies to date did not indicate a major benefit of RTME over LTME.