Gaoyang Cao, Yaoyao Zhao, Xinjie Zhang, Da Man, Fei Wang, Xianlei Cai
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引用次数: 0
摘要
背景：机器人辅助手术（RAS）越来越多地用于治疗低位直肠癌。在提高长期肛门功能方面，机器人辅助手术与腹腔镜手术（LAS）的比较效果仍不确定：方法：我们进行了一项荟萃分析，比较了接受 RAS 和 LAS 手术的患者的长期肛门功能结果。为评估现有证据，进行了元回归和敏感性分析。纳入了截至 2023 年 9 月发表的英文或中文研究：结果：共发现七项研究。与LAS患者相比，RAS患者的低前切除综合征（LARS）评分（标准化平均差[SMD] = -1.39; 95%置信区间[CI]：-2.64至-0.15）和Wexner评分（SMD = -0.74; 95%置信区间[CI]：-1.20至-0.27）较低。然而，RAS并没有明显降低重大LARS风险（几率比=0.85；95% CI：0.68-1.04）：结论：与 LAS 相比，RAS 稍微改善了术后肛门功能。结论：与 LAS 相比，RAS 稍微改善了术后肛门功能。我们需要进一步开展大样本研究，以证实或更新我们的发现。
Comparing the long-term follow-up anal function between robot-assisted and laparoscopic surgery for low rectal cancer: A meta-analysis and systematic review
Background
Robotic-assisted surgery (RAS) is increasingly used for treating low rectal cancer. Its comparative effectiveness against laparoscopic surgery (LAS) in enhancing long-term anal function remains uncertain.
Methods
A meta-analysis was conducted to compare long-term anal function outcomes between patients undergoing RAS and LAS. Meta-regression and sensitivity analyses were performed to assess available evidence. Studies published up to September 2023 in English or Chinese were included.
Results
Seven studies were identified. RAS patients exhibited lower low anterior resection syndrome (LARS) scores (standardised mean difference [SMD] = −1.39; 95% confidence interval [CI]: −2.64 to −0.15) and Wexner scores (SMD = −0.74; 95% CI: −1.20 to −0.27) compared with LAS patients. However, RAS did not significantly reduce major LARS risk (odds ratio = 0.85; 95% CI: 0.68–1.04).
Conclusions
RAS slightly improved postoperative anal function compared with LAS. Further studies with large samples are warranted to confirm or update our findings.
期刊介绍：
The International Journal of Medical Robotics and Computer Assisted Surgery provides a cross-disciplinary platform for presenting the latest developments in robotics and computer assisted technologies for medical applications. The journal publishes cutting-edge papers and expert reviews, complemented by commentaries, correspondence and conference highlights that stimulate discussion and exchange of ideas. Areas of interest include robotic surgery aids and systems, operative planning tools, medical imaging and visualisation, simulation and navigation, virtual reality, intuitive command and control systems, haptics and sensor technologies. In addition to research and surgical planning studies, the journal welcomes papers detailing clinical trials and applications of computer-assisted workflows and robotic systems in neurosurgery, urology, paediatric, orthopaedic, craniofacial, cardiovascular, thoraco-abdominal, musculoskeletal and visceral surgery. Articles providing critical analysis of clinical trials, assessment of the benefits and risks of the application of these technologies, commenting on ease of use, or addressing surgical education and training issues are also encouraged. The journal aims to foster a community that encompasses medical practitioners, researchers, and engineers and computer scientists developing robotic systems and computational tools in academic and commercial environments, with the intention of promoting and developing these exciting areas of medical technology.
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