期刊论文详细信息
World Journal of Surgical Oncology
Robotic-assisted versus laparoscopic colorectal surgery: a meta-analysis of four randomized controlled trials
Haijun Deng3  Jiarong Chen1  Shasha Du1  Yawei Yuan1  Rong Li1  Shuhui Lin1  Zhihong Zhao2  Guixiang Liao1 
[1] Department of Radiation Oncology, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China;Institute of Nephrology and Urology, Third Affiliated Hospital of Southern Medical University, Guangzhou 510630, China;Department of General Surgery, Nanfang Hospital, Southern Medical University, No. 1838, Guangzhou Avenue North, Guangzhou 510515, China
关键词: Colorectal cancer;    Meta-analysis;    Laparoscopic;    Robotic;    Colorectal;   
Others  :  819725
DOI  :  10.1186/1477-7819-12-122
 received in 2014-01-28, accepted in 2014-04-09,  发布年份 2014
PDF
【 摘 要 】

Background

Robotic-assisted laparoscopy is popularly performed for colorectal disease. The objective of this meta-analysis was to compare the safety and efficacy of robotic-assisted colorectal surgery (RCS) and laparoscopic colorectal surgery (LCS) for colorectal disease based on randomized controlled trial studies.

Methods

Literature searches of electronic databases (Pubmed, Web of Science, and Cochrane Library) were performed to identify randomized controlled trial studies that compared the clinical or oncologic outcomes of RCS and LCS. This meta-analysis was performed using the Review Manager (RevMan) software (version 5.2) that is provided by the Cochrane Collaboration. The data used were mean differences and odds ratios for continuous and dichotomous variables, respectively. Fixed-effects or random-effects models were adopted according to heterogeneity.

Results

Four randomized controlled trial studies were identified for this meta-analysis. In total, 110 patients underwent RCS, and 116 patients underwent LCS. The results revealed that estimated blood losses (EBLs), conversion rates and times to the recovery of bowel function were significantly reduced following RCS compared with LCS. There were no significant differences in complication rates, lengths of hospital stays, proximal margins, distal margins or harvested lymph nodes between the two techniques.

Conclusions

RCS is a promising technique and is a safe and effective alternative to LCS for colorectal surgery. The advantages of RCS include reduced EBLs, lower conversion rates and shorter times to the recovery of bowel function. Further studies are required to define the financial effects of RCS and the effects of RCS on long-term oncologic outcomes.

【 授权许可】

   
2014 Liao et al.; licensee BioMed Central Ltd.

【 预 览 】
附件列表
Files Size Format View
20140712012850738.pdf 1738KB PDF download
Figure 13. 39KB Image download
Figure 4. 90KB Image download
Figure 11. 51KB Image download
Figure 10. 47KB Image download
Figure 9. 53KB Image download
Figure 8. 53KB Image download
Figure 7. 46KB Image download
Figure 6. 53KB Image download
Figure 5. 46KB Image download
Figure 4. 52KB Image download
Figure 3. 64KB Image download
Figure 2. 124KB Image download
Figure 1. 99KB Image download
【 图 表 】

Figure 1.

Figure 2.

Figure 3.

Figure 4.

Figure 5.

Figure 6.

Figure 7.

Figure 8.

Figure 9.

Figure 10.

Figure 11.

Figure 4.

Figure 13.

【 参考文献 】
  • [1]Jacobs M, Verdeja JC, Goldstein HS: Minimally invasive colon resection (laparoscopic colectomy). Surg Laparosc Endosc 1991, 1:144-150.
  • [2]Weber PA, Merola S, Wasielewski A, Ballantyne GH: Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease. Dis Colon Rectum 2002, 45:1689-1694. 1695–1696
  • [3]Delaney CP, Lynch AC, Senagore AJ, Fazio VW: Comparison of robotically performed and traditional laparoscopic colorectal surgery. Dis Colon Rectum 2003, 46:1633-1639.
  • [4]D'Annibale A, Morpurgo E, Fiscon V, Trevisan P, Sovernigo G, Orsini C, Guidolin D: Robotic and laparoscopic surgery for treatment of colorectal diseases. Dis Colon Rectum 2004, 47:2162-2168.
  • [5]D'Annibale A, Pernazza G, Morpurgo E, Monsellato I, Pende V, Lucandri G, Termini B, Orsini C, Sovernigo G: Robotic right colon resection: evaluation of first 50 consecutive cases for malignant disease. Ann Surg Oncol 2010, 17:2856-2862.
  • [6]Park JS, Choi GS, Lim KH, Jang YS, Jun SH: Robotic-assisted versus laparoscopic surgery for low rectal cancer: case-matched analysis of short-term outcomes. Ann Surg Oncol 2010, 17:3195-3202.
  • [7]Baik SH, Kwon HY, Kim JS, Hur H, Sohn SK, Cho CH, Kim H: Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study. Ann Surg Oncol 2009, 16:1480-1487.
  • [8]Kim JY, Kim NK, Lee KY, Hur H, Min BS, Kim JH: A comparative study of voiding and sexual function after total mesorectal excision with autonomic nerve preservation for rectal cancer: laparoscopic versus robotic surgery. Ann Surg Oncol 2012, 19:2485-2493.
  • [9]Bianchi PP, Ceriani C, Locatelli A, Spinoglio G, Zampino MG, Sonzogni A, Crosta C, Andreoni B: Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomes. Surg Endosc 2010, 24:2888-2894.
  • [10]Rawlings AL, Woodland JH, Vegunta RK, Crawford DL: Robotic versus laparoscopic colectomy. Surg Endosc 2007, 21:1701-1708.
  • [11]Jimenez-Rodriguez RM, Diaz-Pavon JM, de la Portilla DJF, Prendes-Sillero E, Dussort HC, Padillo J: Learning curve for robotic-assisted laparoscopic rectal cancer surgery. Int J Colorectal Dis 2013, 28:815-821.
  • [12]Higgins JP, Altman DG, Gotzsche PC, Juni P, Moher D, Oxman AD, Savovic J, Schulz KF, Weeks L, Sterne JA: The Cochrane collaboration's tool for assessing risk of bias in randomised trials. BMJ 2011, 343:d5928.
  • [13]Park JS, Choi GS, Park SY, Kim HJ, Ryuk JP: Randomized clinical trial of robot-assisted versus standard laparoscopic right colectomy. Br J Surg 2012, 99:1219-1226.
  • [14]Patriti A, Ceccarelli G, Bartoli A, Spaziani A, Biancafarina A, Casciola L: Short- and medium-term outcome of robot-assisted and traditional laparoscopic rectal resection. JSLS 2009, 13:176-183.
  • [15]Baik SH, Ko YT, Kang CM, Lee WJ, Kim NK, Sohn SK, Chi HS, Cho CH: Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial. Surg Endosc 2008, 22:1601-1608.
  • [16]Jimenez RR, Diaz PJ, de La Portilla DJF, Prendes SE, Hisnard CDJ, Padillo J: Prospective randomised study: robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection. Cir Esp 2011, 89:432-438.
  • [17]Ma Y, Yang Z, Qin H, Wang Y: A meta-analysis of laparoscopy compared with open colorectal resection for colorectal cancer. Med Oncol 2011, 28:925-933.
  • [18]Abraham NS, Young JM, Solomon MJ: Meta-analysis of short-term outcomes after laparoscopic resection for colorectal cancer. Br J Surg 2004, 91:1111-1124.
  • [19]Buunen M, Veldkamp R, Hop WC, Kuhry E, Jeekel J, Haglind E, Pahlman L, Cuesta MA, Msika S, Morino M, Lacy A, Bonjer HJ: Survival after laparoscopic surgery versus open surgery for colon cancer: long-term outcome of a randomised clinical trial. Lancet Oncol 2009, 10:44-52.
  • [20]Guillou PJ, Quirke P, Thorpe H, Walker J, Jayne DG, Smith AM, Heath RM, Brown JM: Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trial. Lancet 2005, 365:1718-1726.
  • [21]Challacombe B, Wheatstone S: Telementoring and telerobotics in urological surgery. Curr Urol Rep 2010, 11:22-28.
  • [22]Liao G, Chen J, Ren C, Li R, Du S, Xie G, Deng H, Yang K, Yuan Y: Robotic versus open gastrectomy for gastric cancer: a meta-analysis. PLoS One 2013, 8:e81946.
  • [23]Scandola M, Grespan L, Vicentini M, Fiorini P: Robot-assisted laparoscopic hysterectomy vs traditional laparoscopic hysterectomy: five metaanalyses. J Minim Invasive Gynecol 2011, 18:705-715.
  • [24]Maeso S, Reza M, Mayol JA, Blasco JA, Guerra M, Andradas E, Plana MN: Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systematic review and meta-analysis. Ann Surg 2010, 252:254-262.
  • [25]Yang Y, Wang F, Zhang P, Shi C, Zou Y, Qin H, Ma Y: Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis. Ann Surg Oncol 2012, 19:3727-3736.
  • [26]Spinoglio G, Summa M, Priora F, Quarati R, Testa S: Robotic colorectal surgery: first 50 cases experience. Dis Colon Rectum 2008, 51:1627-1632.
  • [27]Deutsch GB, Sathyanarayana SA, Gunabushanam V, Mishra N, Rubach E, Zemon H, Klein JD, Denoto GR: Robotic vs. laparoscopic colorectal surgery: an institutional experience. Surg Endosc 2012, 26:956-963.
  • [28]Baek SJ, Kim SH, Cho JS, Shin JW, Kim J: Robotic versus conventional laparoscopic surgery for rectal cancer: a cost analysis from a single institute in Korea. World J Surg 2012, 36:2722-2729.
  • [29]Patel CB, Ragupathi M, Ramos-Valadez DI, Haas EM: A three-arm (laparoscopic, hand-assisted, and robotic) matched-case analysis of intraoperative and postoperative outcomes in minimally invasive colorectal surgery. Dis Colon Rectum 2011, 54:144-150.
  • [30]Poon JT, Law WL: Laparoscopic resection for rectal cancer: a review. Ann Surg Oncol 2009, 16:3038-3047.
  • [31]Kim CW, Kim CH, Baik SH: Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 2014, 18:816-830.
  • [32]Amato A, Pescatori M: Perioperative blood transfusions for the recurrence of colorectal cancer. Cochrane Database Syst Rev 2006, 7:D5033.
  • [33]Morner ME, Gunnarsson U, Jestin P, Svanfeldt M: The importance of blood loss during colon cancer surgery for long-term survival: an epidemiological study based on a population based register. Ann Surg 2012, 255:1126-1128.
  • [34]Bhangu A, Brown G, Akmal M, Tekkis P: Outcome of abdominosacral resection for locally advanced primary and recurrent rectal cancer. Br J Surg 2012, 99:1453-1461.
  • [35]McPartland KJ, Hyman NH: Damage control: what is its role in colorectal surgery? Dis Colon Rectum 2003, 46:981-986.
  • [36]Mirnezami AH, Mirnezami R, Venkatasubramaniam AK, Chandrakumaran K, Cecil TD, Moran BJ: Robotic colorectal surgery: hype or new hope? A systematic review of robotics in colorectal surgery. Colorectal Dis 2010, 12:1084-1093.
  • [37]Pigazzi A, Luca F, Patriti A, Valvo M, Ceccarelli G, Casciola L, Biffi R, Garcia-Aguilar J, Baek JH: Multicentric study on robotic tumor-specific mesorectal excision for the treatment of rectal cancer. Ann Surg Oncol 2010, 17:1614-1620.
  • [38]Keller DS, Senagore AJ, Lawrence JK, Champagne BJ, Delaney CP: Comparative effectiveness of laparoscopic versus robot-assisted colorectal resection. Surg Endosc 2014, 28:212-221.
  • [39]DeSouza AL, Prasad LM, Park JJ, Marecik SJ, Blumetti J, Abcarian H: Robotic assistance in right hemicolectomy: is there a role? Dis Colon Rectum 2010, 53:1000-1006.
  • [40]Halabi WJ, Kang CY, Jafari MD, Nguyen VQ, Carmichael JC, Mills S, Stamos MJ, Pigazzi A: Robotic-assisted colorectal surgery in the United States: a nationwide analysis of trends and outcomes. World J Surg 2013, 37:2782-2790.
  • [41]Aly EH: Robotic colorectal surgery: summary of the current evidence. Int J Colorectal Dis 2014, 29:1-8.
  文献评价指标  
  下载次数:112次 浏览次数:13次