Department of General Surgery, Suzhou Ninth Hospital Affiliated to Soochow University, Suzhou, 215000, Jiangsu, China.
J Robot Surg. 2024 Jun 22;18(1):262. doi: 10.1007/s11701-024-02019-0.
The purpose of the study was to compare the protective effects of robotic rectal cancer surgery (RRCS) and laparoscopic rectal cancer surgery (LRCS) on urinary and sexual function of patients. We conducted a systematic search in the PubMed, Web of Science, Cochrane Library, and Embase for studies comparing the impact of RRCS and LRCS on urinary function and sexual function. The International Prostate Symptom Score (IPSS), the five-item version of the International Index of Erectile Function (IIEF-5) and the Female Sexual Function Index(FSFI) were used to evaluate the urinary function and sexual function of patients. A total of 13 studies comprising 1964 patients were included in this meta-analysis, including 3 randomized controlled trials, 5 retrospective cohort studies, 3 prospective cohort studies, and 2 propensity score-matched studies. Nine hundred and fifty-nine patients underwent RRCS and 1005 patients underwent LRCS. Statistical analysis of the IPSS scores indicated urinary function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12 months postoperatively [mean difference (MD), - 1.06, 95% CI - 1.85 to - 0.28; and MD, - 0.96, 95% CI - 1.60 to - 0.32; and MD, - 1.09, 95% CI - 1.72 to - 0.46]. Statistical analysis of the IIEF-5 scores indicated male sexual function was significantly better in the RRCS group than in the LRCS group at 3, 6 and 12 months postoperatively (MD, 1.76, 95% CI 0.80 to 2.72; and MD, 1.83, 95% CI 0.34 to 3.33; and MD, 1.05, 95% CI 0.09 to 2.01). Statistical analysis of the FSFI scores indicated female sexual function was significantly better in the RRCS group than in the LRCS group at 6 and 12 months postoperatively (MD, 2.86; 95% CI 1.38 to 4.35; and MD, 4.19; 95% CI 1.85 to 6.54). RRCS is more favorable than LRCS in preserving the urinary and sexual function of patients with rectal cancer.
本研究旨在比较机器人直肠癌手术（RRCS）和腹腔镜直肠癌手术（LRCS）对患者尿控和性功能的保护作用。我们系统检索了 PubMed、Web of Science、Cochrane Library 和 Embase 中比较 RRCS 和 LRCS 对尿控和性功能影响的研究。采用国际前列腺症状评分（IPSS）、国际勃起功能指数（IIEF-5）的五分量表和女性性功能指数（FSFI）评估患者的尿控和性功能。共有 13 项研究，包括 1964 例患者纳入荟萃分析，其中 3 项为随机对照试验，5 项为回顾性队列研究，3 项为前瞻性队列研究，2 项为倾向评分匹配研究。959 例患者接受 RRCS，1005 例患者接受 LRCS。术后 3、6 和 12 个月时，RRCS 组的 IPSS 评分表明尿控功能明显优于 LRCS 组[平均差值（MD），-1.06，95%置信区间（CI）-1.85 至-0.28；MD，-0.96，95% CI -1.60 至-0.32；MD，-1.09，95% CI -1.72 至-0.46]。RRCS 组在术后 3、6 和 12 个月时 IIEF-5 评分表明男性性功能明显优于 LRCS 组（MD，1.76，95% CI 0.80 至 2.72；MD，1.83，95% CI 0.34 至 3.33；MD，1.05，95% CI 0.09 至 2.01）。RRCS 组在术后 6 和 12 个月时 FSFI 评分表明女性性功能明显优于 LRCS 组（MD，2.86；95% CI 1.38 至 4.35；MD，4.19；95% CI 1.85 至 6.54）。RRCS 在保护直肠癌患者的尿控和性功能方面优于 LRCS。
