Hu Ming, Miao Changfeng, Wang Xiaopeng, Ma Yuntao
Department of General Surgery, Gansu Provincial People's Hospital, Lanzhou, China.
Medicine (Baltimore). 2018 Apr;97(15):e0396. doi: 10.1097/MD.0000000000010396.
Although the safety and the advantages of laparoscopic and robotic colorectal surgeries have been confirmed, the use of both modalities in patients with previous abdominal surgeries (PAS) history remains uncertain. Herein, we perform a meta-analysis to investigate the impact of PAS on perioperative recovery outcomes from laparoscopic and robotic colorectal surgeries.
We will search PUBMED, the Cochrane Library, the Chinese Biomedical database (CBM), WanFang data, China National Knowledge Infrastructure (CNKI) up to January 2018. Studies will be screened by title, abstract, and full text independently and in duplicate. Studies that report the impact of PAS on perioperative recovery outcomes from laparoscopic and robotic colorectal surgeries will be eligible for inclusion. Outcome variables will be assessed included combined resection, conversion, operation time, blood loss, number of retrieved lymph nodes, days to soft diet intake, length of hospital stay, and postoperative complications. Assessment of risk of bias and data synthesis will be performed using STATA SE 12.0. Heterogeneity among studies will be assessed using the I statistic.
Randomized controlled trials, prospective cohort studies, and propensity-matched comparative studies will be used for the quantitative synthesis of the meta-analysis to evaluate the impact of PAS on perioperative recovery outcomes from laparoscopic and robotic colorectal surgeries.
We aim to draw an objective conclusion of the comparisons in aspects of perioperative outcomes and provide physicians level I evidences for clinical decision makings.
尽管腹腔镜和机器人结直肠手术的安全性及优势已得到证实,但对于有腹部手术史(PAS)的患者使用这两种手术方式的情况仍不明确。在此,我们进行一项荟萃分析,以研究PAS对腹腔镜和机器人结直肠手术围手术期恢复结局的影响。
我们将检索截至2018年1月的PUBMED、Cochrane图书馆、中国生物医学数据库(CBM)、万方数据、中国知网。研究将由两名研究者独立地通过标题、摘要和全文进行筛选。报告PAS对腹腔镜和机器人结直肠手术围手术期恢复结局影响的研究将纳入分析。将评估的结局变量包括联合切除、中转、手术时间、失血量、获取的淋巴结数量、开始进食软食的天数、住院时间及术后并发症。将使用STATA SE 12.0进行偏倚风险评估和数据合成。将使用I统计量评估研究间的异质性。
随机对照试验、前瞻性队列研究和倾向匹配比较研究将用于荟萃分析的定量合成,以评估PAS对腹腔镜和机器人结直肠手术围手术期恢复结局的影响。
我们旨在得出围手术期结局比较的客观结论,并为临床决策提供I级医师证据。