Department of Oncology, Shenzhen People's Hospital, Second Clinical Medicine Centre, Jinan University, Shenzhen, China.
Department of Nephrology, Shenzhen People's Hospital, Second Clinical Medicine Centre, Jinan University, Shenzhen, China.
Int J Med Robot. 2019 Oct;15(5):e2027. doi: 10.1002/rcs.2027. Epub 2019 Aug 22.
To compare the pathologic outcomes between robotic-assisted rectal cancer surgery (RRCS) and laparoscopic rectal cancer surgery (LRCS) based on randomized controlled trials (RCTs).
Electronic databases were searched from their inception to 7 October 2018, for RCTs involving a comparison between RRCS and LRCS. Positive circumferential resection margin (CRM), distance to the distal margin, proximal margin, the rate of complete mesorectal excision, and harvested lymph nodes were interesting of outcomes.
The positive CRM, proximal margin, and rate of complete mesorectal excision were comparable between the two techniques. RRCS resulted in better outcomes for the distance to the distal margin (mean difference: 0.83 cm, 95% confidence interval, 0.29-1.37, P = .003).
The pathologic outcomes associated with the two approaches were comparable, with RRCS showing better outcomes for the distance to the distal margin. However, additional well-designed studies are needed to assess whether the benefits of pathologic outcomes improve survival outcomes.
基于随机对照试验（RCT）比较机器人辅助直肠癌手术（RRCS）与腹腔镜直肠癌手术（LRCS）的病理结果。
电子数据库从建库起至 2018 年 10 月 7 日进行检索，纳入 RRCS 与 LRCS 比较的 RCT。感兴趣的结局为阳性环周切缘（CRM）、远端切缘距离、近端切缘、完整直肠系膜切除率和采集的淋巴结数。
两种技术的阳性 CRM、近端切缘和完整直肠系膜切除率相当。RRCS 可获得更好的远端切缘距离（均数差：0.83cm，95%置信区间，0.29-1.37，P=0.003）。
两种方法的病理结果相当，RRCS 显示出更好的远端切缘距离。然而，需要更多设计良好的研究来评估病理结果的获益是否改善生存结局。
