Department of General Surgery, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary Disease, Tianjin Third Center Hospital, No.83, Jintang Road, Hedong District, Tianjin, 300170, China.
School of nursing, Tianjin Medical University, No.22, Qixiangtai Road, Heping District, Tianjin, 300070, China.
Int J Colorectal Dis. 2021 Aug;36(8):1685-1694. doi: 10.1007/s00384-021-03885-y. Epub 2021 Mar 1.
Robotic-assisted surgery and robotic-assisted ventral mesh rectopexy are gaining attention in the treatment of rectal prolapse and increased positive findings are proposed. The objective of this meta-analysis was to investigate whether robotic-assisted ventral mesh rectopexy is comparable with the conventional laparoscopic approach surgery.
Five major databases (PubMed, Sciencedirect, Web of Science, Embase, and Cochrane Library) were searched for eligible studies. Observational studies of the effect and safety of robotic-assisted and laparoscopic approaches on ventral mesh rectopexy were included. Odd ratios (OR) and weight mean difference (WMD) were used for dichotomous data and continuous data analysis. Clinical outcomes, functional outcomes, and cost-effectiveness data were extracted for meta-analysis.
Compared to the laparoscopic approach, a significant shorter length of hospital stay (LOS), lesser intraoperative blood loss, and lower post-operative complication rate of RVMR group were observed. However, operation time of RVMR was significant increased. The expense of RVMR was higher than LVMR; mean Wexner scores and fecal incontinence were lower in RVMR group while there were no statistical differences.
The result of the current analysis revealed that the robotic-assisted ventral mesh rectopexy is effective and feasible in the treatment of rectal prolapse. However, long-term follow-up and results are needed for the promotion of this approach. There is a long way for robotic-assisted surgery to become a gold standard in rectal surgery.
机器人辅助手术和机器人辅助腹侧网片直肠固定术在直肠脱垂的治疗中越来越受到关注，提出了更多阳性发现。本荟萃分析的目的是研究机器人辅助腹侧网片直肠固定术是否与传统腹腔镜手术相当。
检索了五个主要数据库（PubMed、Sciencedirect、Web of Science、Embase 和 Cochrane Library）以获取合格的研究。纳入了机器人辅助和腹腔镜方法对腹侧网片直肠固定术的效果和安全性的观察性研究。二项数据和连续数据分析使用比值比（OR）和加权均数差（WMD）。提取临床结果、功能结果和成本效益数据进行荟萃分析。
与腹腔镜方法相比，RVMR 组的住院时间（LOS）明显缩短，术中出血量减少，术后并发症发生率降低。然而，RVMR 的手术时间明显增加。RVMR 的费用高于 LVMR；RVMR 组的 Wexner 平均评分和粪便失禁较低，但无统计学差异。
目前分析的结果表明，机器人辅助腹侧网片直肠固定术在直肠脱垂的治疗中是有效且可行的。然而，需要长期随访和结果来推广这种方法。机器人辅助手术要成为直肠手术的金标准还有很长的路要走。
