Division of Digestive Surgery, University Hospitals of Geneva, Rue Gabrielle-Perret-Gentil,14, 41211, Geneva, Switzerland.
Medical School, University of Geneva, Rue Michel-Servet, 11206, Geneva, Switzerland.
J Robot Surg. 2024 Mar 11;18(1):116. doi: 10.1007/s11701-024-01862-5.
Robotics may facilitate the realization of fully minimally invasive right hemicolectomy, including intra-corporeal anastomosis and off-midline extraction, when compared to laparoscopy. Our aim was to compare laparoscopic right hemicolectomy with robotic right hemicolectomy in terms of peri-operative outcomes. MEDLINE was searched for original studies comparing laparoscopic right hemicolectomy with robotic right hemicolectomy in terms of peri-operative outcomes. The systematic review complied with the PRISMA 2020 recommendations. Variables related to patients' demographics, surgical procedures, post-operative recovery and pathological outcomes were collected and qualitatively assessed. Two-hundred and ninety-three publications were screened, 277 were excluded and 16 were retained for qualitative analysis. The majority of included studies were observational and of limited sample size. When the type of anastomosis was left at surgeon's discretion, intra-corporeal anastomosis was favoured in robotic right hemicolectomy (4/4 studies). When compared to laparoscopy, robotics allowed harvesting more lymph nodes (4/15 studies), a lower conversion rate to open surgery (5/14 studies), a shorter time to faeces (2/3 studies) and a shorter length of stay (5/14 studies), at the cost of a longer operative time (13/14 studies). Systematic review of existing studies, which are mostly non-randomized, suggests that robotic surgery may facilitate fully minimally invasive right hemicolectomy, including intra-corporeal anastomosis, and offer improved post-operative recovery.
与腹腔镜相比，机器人手术可能有助于实现完全微创的右半结肠切除术，包括腔内吻合术和偏离中线的取出术。我们的目的是比较腹腔镜右半结肠切除术和机器人右半结肠切除术在围手术期结果方面的差异。检索 MEDLINE 中比较腹腔镜右半结肠切除术和机器人右半结肠切除术在围手术期结果方面的原始研究。系统评价符合 PRISMA 2020 建议。收集并定性评估与患者人口统计学、手术程序、术后恢复和病理结果相关的变量。筛选了 293 篇出版物，排除了 277 篇，保留了 16 篇进行定性分析。大多数纳入的研究是观察性的，样本量有限。当吻合类型由外科医生决定时，机器人右半结肠切除术更倾向于采用腔内吻合术（4/4 项研究）。与腹腔镜相比，机器人手术可以采集更多的淋巴结（4/15 项研究）、更低的中转开腹率（5/14 项研究）、粪便时间更短（2/3 项研究）和住院时间更短（5/14 项研究），但手术时间更长（13/14 项研究）。对现有研究的系统评价表明，机器人手术可能有助于实现完全微创的右半结肠切除术，包括腔内吻合术，并提供更好的术后恢复。
