Instituto de Ensino, Pesquisa e Inovação Liga Contra o Câncer - Natal (RN) - Brazil.
Universidade Potiguar - Department of Medicine - Natal (RN) - Brazil.
Acta Cir Bras. 2024 Oct 25;39:e397224. doi: 10.1590/acb397224. eCollection 2024.
To compare robotic versus laparoscopic colectomies in colon cancer patients in general complications.
Nine databases were searched for randomized controlled trials (RCT) investigating patients with colon cancer, submitted to robotic surgery (RS) compared to a laparoscopic (LC) approach. The risk of bias was assessed using RoB 2.0 tool, and certainty of the evidence was evaluated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Data synthesis was performed using the software R. The meta-analysis of the included studies was carried out using the fixed-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis.
A total of four studies were used with 293 patients. Three studies were used in this comparative LC vs. RS when evaluating infection rates on surgical wound sites. The odds ratio (OR) appeared to be slightly favorable to LC (OR = 3.05; 95% confidence interval-95%CI 0.78-11.96). In the hospitalization rates analysis, two randomized controlled trials were used, and the mean differences slightly favored the RS (MD = -0.54; 95%CI -2.28-1.19). GRADE evaluation detected a serious risk of bias due to RCT format and RoB-2 concurred.
Both types of procedures seem to have their own benefits, risks, and limitations. They seem close to equal in terms of postsurgical infection and hospitalization.
比较机器人辅助结肠切除术与腹腔镜结肠切除术在结肠癌患者总体并发症方面的差异。
检索了 9 个数据库，以寻找针对接受机器人手术（RS）与腹腔镜（LC）手术的结肠癌患者的随机对照试验（RCT）。使用 RoB 2.0 工具评估偏倚风险，并使用推荐评估、制定与评价（GRADE）系统评估证据确定性。使用 R 软件进行数据分析。使用固定效应模型（DerSimonian 和 Laird）对纳入研究进行荟萃分析。使用 I2 分析评估异质性。
共有 4 项研究，涉及 293 名患者。其中 3 项研究用于比较 LC 与 RS 时评估手术部位感染率。优势比（OR）似乎略微有利于 LC（OR=3.05；95%置信区间-95%CI 0.78-11.96）。在住院率分析中，使用了两项随机对照试验，平均差异略微有利于 RS（MD=-0.54；95%置信区间-2.28-1.19）。GRADE 评估发现由于 RCT 格式存在严重的偏倚风险，RoB-2 也一致认为存在偏倚。
两种手术类型似乎都有各自的优势、风险和局限性。在术后感染和住院方面，它们似乎相当。
