Lian Jiming, Li Jinbiao, Liu Cong, Luan BaoDong, Miao Yanmin
College of Basic Medical Sciences, Guangdong Yunfu Vocational College of Chinese Medicine, Yunfu, 527300, China.
Department of Neurology, The First Affiliated Hospital of Sun Yat-sen University, Guangzhou, 510000, China.
J Robot Surg. 2024 Mar 23;18(1):135. doi: 10.1007/s11701-024-01872-3.
Rectal cancer is one of the most common malignant tumours worldwide, and it is also one of the major diseases that seriously threatens human life and health. At present, the main treatment for rectal cancer is still surgical treatment. The surgical methods have been rapidly developed from the previous open surgery to the current minimally invasive surgery. At present, there are two main minimally invasive surgeries: robotic surgery and laparoscopic surgery. Due to the particularity of rectal cancer surgery, more and more studies have shown that robotic rectal cancer surgery has more advantages than laparoscopic rectal cancer surgery. However, whether the incidence of postoperative complications after robotic rectal cancer surgery is lower than that after laparoscopy is not uniformly conclusive in the current study. Therefore, in this paper, we searched Pubmed, Cochrane Library, Embase and other databases, collected the latest published meta-analysis on postoperative complications of robots and laparoscopy in rectal cancer, and assessed the quality of the included meta-analysis by AMSTAR-2 evaluation tool, so as to explore the current research status and research quality of postoperative complications of robots and laparoscopy in rectal cancer. The results showed that compared with laparoscopic rectal cancer surgery, robotic rectal cancer surgery could improve the postoperative urinary and reproductive function of male patients, but it could not be proved that robotic rectal cancer surgery could reduce the incidence of postoperative complications, anastomotic leakage, urinary retention, intestinal obstruction, anastomotic bleeding, incision infection, pulmonary infection, venous thrombosis and abdominal abscess; however, the overall quality of meta-analysis of the results of each complication was low or very low. Therefore, multicenter, large-sample, high-quality prospective randomised controlled studies and high-quality meta-analysis are still needed to prove the advantages of robotic rectal cancer surgery in postoperative complications in the future.
直肠癌是全球最常见的恶性肿瘤之一，也是严重威胁人类生命健康的主要疾病之一。目前，直肠癌的主要治疗方法仍是手术治疗。手术方式已从以往的开放手术迅速发展到目前的微创手术。目前，主要的微创手术有两种：机器人手术和腹腔镜手术。由于直肠癌手术的特殊性，越来越多的研究表明，机器人直肠癌手术比腹腔镜直肠癌手术具有更多优势。然而，目前的研究对于机器人直肠癌手术后的并发症发生率是否低于腹腔镜手术尚无统一定论。因此，在本文中，我们检索了PubMed、Cochrane图书馆、Embase等数据库，收集了最新发表的关于机器人手术和腹腔镜手术治疗直肠癌术后并发症的荟萃分析，并通过AMSTAR-2评估工具评估纳入的荟萃分析的质量，以探讨机器人手术和腹腔镜手术治疗直肠癌术后并发症的当前研究现状和研究质量。结果显示，与腹腔镜直肠癌手术相比，机器人直肠癌手术可改善男性患者术后的泌尿和生殖功能，但无法证明机器人直肠癌手术可降低术后并发症、吻合口漏、尿潴留、肠梗阻、吻合口出血、切口感染、肺部感染、静脉血栓形成和腹腔脓肿的发生率；然而，各并发症结果的荟萃分析总体质量较低或非常低。因此，未来仍需要多中心、大样本、高质量的前瞻性随机对照研究和高质量的荟萃分析来证明机器人直肠癌手术在术后并发症方面的优势。
