Panteleimonitis Sofoklis, Ahmed Jamil, Harper Mick, Parvaiz Amjad
Sofoklis Panteleimonitis, Jamil Ahmed, Amjad Parvaiz, Department of Colorectal Surgery, Poole Hospital, Dorset BH15 2JB, United Kingdom.
World J Gastrointest Surg. 2016 Nov 27;8(11):744-754. doi: 10.4240/wjgs.v8.i11.744.
To analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery.
A comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: "rectal cancer" or "colorectal cancer" and robot* or "da Vinci" and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors.
Fifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726 (54%) patients had their urogenital function assessed means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and three sexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions.
There seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.
分析目前关于接受机器人直肠癌手术患者泌尿生殖功能结局的文献。
2015年10月对电子数据库进行了全面的文献检索。使用了以下检索词：“直肠癌”或“结直肠癌”以及机器人或“达芬奇”以及性或泌尿或尿或勃起或射精或阳痿*或失禁。纳入所有研究接受机器人直肠癌手术的男性和/或女性患者泌尿和/或性功能结局的原始研究。对所有检索到的文章的参考文献列表进行人工搜索以查找更多相关文章。摘要由两位作者独立检索。
15项原始研究符合纳入标准。共纳入1338例患者；818例接受机器人手术，498例接受腹腔镜手术，22例接受开放直肠癌手术。只有726例（54%）患者通过有效的功能问卷对其泌尿生殖功能进行了评估。在所纳入的研究中，三项研究发现与腹腔镜手术相比，机器人直肠癌手术可使男性泌尿功能恢复更快，五项研究发现可使男性性功能恢复更快。从长远来看，机器人手术是否能为男性带来良好的泌尿生殖结局尚不清楚。在女性患者中，只有两项研究独立于男性评估了泌尿功能，三项研究评估了性功能。在这些研究中，接受机器人和腹腔镜直肠癌手术的患者之间未发现差异。然而，在女性中，所提供的证据非常有限，无法得出任何实质性结论。
机器人手术后男性泌尿生殖功能似乎有更早恢复的趋势。为了进一步评估这一点，需要进行更大规模、设计良好的研究。
