Joachim Cheng En Ho, Aryan Raj Goel, Muriel Sirgi, Ayan Bin Rafaih, Ayaz Ahmed Memon, Irshad Shaikh, Muhammad Rafaih Iqbal
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引用次数: 0
Abstract
Robotic surgery is increasingly utilized for rectal cancer resection, particularly in cases requiring beyond total mesorectal excision (bTME) to achieve oncological clearance. Despite longer operative times, robotic bTME has been associated with reduced morbidity and blood loss, making it an emerging approach in specialized centers. A systematic review following PRISMA guidelines was conducted in Web of Science, PubMed, and Scopus. Studies reporting robotic bTME for recurrent or locally advanced anorectal cancer were included. Outcomes assessed included study characteristics, demographics, operative outcomes, oncological data, and follow-up. Nineteen studies comprising 1027 patients met the inclusion criteria (13 case series-68% and 6 cohort studies-32%). The median patient age ranged from 51 to 68 years with 73.7% males. Most patients had an ASA score of 2 (53.1%), and BMI ranged from 21.1 to 28.6. Tumor locations were predominantly near the anal verge (median: 3-6 cm), and the most common clinical staging was cT3, cN1, and cM0. Surgical complications included urinary issues (22.6%), anastomotic leakage (11.4%), ileus (10.4%), and bleeding (5.3%). Follow-up data indicated a recurrence rate of 24.9%, and the 1-year survival rate was > 90%. These studies reported an overall complication rate of 49.7%, with a median follow-up of 12-36 months. Oncological outcomes were favorable, although there was significant variability in survival data between studies. The heterogenicity of the studies makes it challenging to conclusively establish robotic bTME as a feasible alternative to the gold standard. Further prospective studies, with measurable outcomes and consistent terminology, are needed to ensure homogeneity.
期刊介绍:
The aim of the Journal of Robotic Surgery is to become the leading worldwide journal for publication of articles related to robotic surgery, encompassing surgical simulation and integrated imaging techniques. The journal provides a centralized, focused resource for physicians wishing to publish their experience or those wishing to avail themselves of the most up-to-date findings.The journal reports on advance in a wide range of surgical specialties including adult and pediatric urology, general surgery, cardiac surgery, gynecology, ENT, orthopedics and neurosurgery.The use of robotics in surgery is broad-based and will undoubtedly expand over the next decade as new technical innovations and techniques increase the applicability of its use. The journal intends to capture this trend as it develops.