Department of Radiation Oncology, Shenzhen People's Hospital, Second Clinical Medicine College of Jinan University, China.
Department of Hepatobiliary and Pancreatic Surgery, Taihe Hospital, Hubei University of Medicine, Hubei, China.
Sci Rep. 2016 May 27;6:26981. doi: 10.1038/srep26981.
The aim of this meta-analysis was to comprehensively compare the safety and efficacy of robotic-assisted rectal cancer surgery (RRCS) and open rectal cancer surgery (ORCS). Electronic database (PubMed, EMBASE, Web of Knowledge, and the Cochrane Library) searches were conducted for all relevant studies that compared the short-term and long-term outcomes between RRCS and ORCS. Odds ratios (ORs), mean differences, and hazard ratios were calculated. Seven studies involving 1074 patients with rectal cancer were identified for this meta-analysis. Compared with ORCS, RRCS is associated with a lower estimated blood loss (mean difference [MD]: -139.98, 95% confidence interval [CI]: -159.11 to -120.86; P < 0.00001), shorter hospital stay length (MD: -2.10, 95% CI: -3.47 to -0.73; P = 0.003), lower intraoperative transfusion requirements (OR: 0.52, 95% CI: 0.28 to 0.99, P = 0.05), shorter time to flatus passage (MD: -0.97, 95% CI = -1.06 to -0.88, P < 0.00001), and shorter time to resume a normal diet (MD: -1.71.95% CI = -3.31 to -0.12, P = 0.04). There were no significant differences in surgery-related complications, oncologic clearance, disease-free survival, and overall survival between the two groups. However, RRCS was associated with a longer operative time. RRCS is safe and effective.
本荟萃分析旨在全面比较机器人辅助直肠癌手术（RRCS）与开腹直肠癌手术（ORCS）的安全性和疗效。对比较 RRCS 和 ORCS 短期和长期结果的所有相关研究进行电子数据库（PubMed、EMBASE、Web of Knowledge 和 Cochrane Library）检索。计算了比值比（ORs）、均数差值和风险比。本荟萃分析纳入了 7 项涉及 1074 例直肠癌患者的研究。与 ORCS 相比，RRCS 术中出血量较少（均数差值 [MD]：-139.98，95%置信区间 [CI]：-159.11 至-120.86；P<0.00001），住院时间较短（MD：-2.10，95% CI：-3.47 至-0.73；P=0.003），术中输血需求较低（OR：0.52，95% CI：0.28 至 0.99，P=0.05），肛门排气时间较短（MD：-0.97，95% CI：-1.06 至-0.88，P<0.00001），恢复正常饮食时间较短（MD：-1.71，95% CI：-3.31 至-0.12，P=0.04）。两组手术相关并发症、肿瘤清除率、无病生存率和总生存率无显著差异。然而，RRCS 的手术时间较长。RRCS 是安全有效的。
