Hua Qiu1, Dongjun Yu2, Shanping Ye1, Renfeng Shan3, Junhua Ai3, Jun Shi4. 1. Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China; Jiangxi Medical College of Nanchang University, Nanchang University Health Science Center, Nanchang, 330006, Jiangxi Province, China. 2. Department of Anesthesiology, First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China. 3. Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China. 4. Department of General Surgery, First Affiliated Hospital of Nanchang University, Nanchang, 330006, Jiangxi Province, China. Electronic address: sj88694129@sina.com.
Abstract
BACKGROUND: Short-term outcomes of robotic mesorectal excision for rectal cancer resection seem comparable to those of conventional laparoscopic mesorectal excision. However, the long-term oncological outcomes of robot mesorectal excision require further investigation. MATERIALS AND METHODS: The PubMed, EMBASE, Medline, and Cochrane Library databases were searched from the date of database inception to March 31, 2019 for all available trials; the results of robotic and laparoscopic mesorectal excision for rectal cancer surgery were compared. Survival parameters, including overall survival (OS) and disease-free survival (DFS), were independently extracted by two investigators. Hazard ratios (HRs) were calculated using random- or fixed-effects models. The presence of heterogeneity was assessed using Q test, and the extent of heterogeneity was quantified by I2 index. The meta-analysis was performed using Review Manager software, version 5.3. RESULTS: A total of seven studies including 2593 patients (1362 treated by robotic mesorectal excision and 1231 by laparoscopic mesorectal excision) were included. Pooled analyses showed no significant difference in OS (HR = 0.94, 95% confidence interval [CI]: 0.63 to 1.39, P = 0.75) or DFS (HR = 0.93, 95% CI: 0.79 to 1.10, P = 0.85) between the robotic and laparoscopic mesorectal excision for treatment of rectal cancer. CONCLUSION: Regarding long-term survival, robotic mesorectal excision for rectal cancer is comparable to laparoscopic mesorectal excision. More prospective, multicenter randomized trials with longer follow-up periods are needed to determine the long-term outcomes of patients undergoing robotic mesorectal excision.
BACKGROUND: Short-term outcomes of robotic mesorectal excision for rectal cancer resection seem comparable to those of conventional laparoscopic mesorectal excision. However, the long-term oncological outcomes of robot mesorectal excision require further investigation. MATERIALS AND METHODS: The PubMed, EMBASE, Medline, and Cochrane Library databases were searched from the date of database inception to March 31, 2019 for all available trials; the results of robotic and laparoscopic mesorectal excision for rectal cancer surgery were compared. Survival parameters, including overall survival (OS) and disease-free survival (DFS), were independently extracted by two investigators. Hazard ratios (HRs) were calculated using random- or fixed-effects models. The presence of heterogeneity was assessed using Q test, and the extent of heterogeneity was quantified by I2 index. The meta-analysis was performed using Review Manager software, version 5.3. RESULTS: A total of seven studies including 2593 patients (1362 treated by robotic mesorectal excision and 1231 by laparoscopic mesorectal excision) were included. Pooled analyses showed no significant difference in OS (HR = 0.94, 95% confidence interval [CI]: 0.63 to 1.39, P = 0.75) or DFS (HR = 0.93, 95% CI: 0.79 to 1.10, P = 0.85) between the robotic and laparoscopic mesorectal excision for treatment of rectal cancer. CONCLUSION: Regarding long-term survival, robotic mesorectal excision for rectal cancer is comparable to laparoscopic mesorectal excision. More prospective, multicenter randomized trials with longer follow-up periods are needed to determine the long-term outcomes of patients undergoing robotic mesorectal excision.
Authors: L J X Giesen; J W T Dekker; M Verseveld; R M P H Crolla; G P van der Schelling; C Verhoef; P B Olthof Journal: Surg Endosc Date: 2022-08-30 Impact factor: 3.453