Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

Background and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci...

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Autores principales:	Jie Zhang, Xingshun Qi, Fangfang Yi, Rongrong Cao, Guangrong Gao, Cheng Zhang
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	da Vinci robot intersphincteric resection laparoscope low rectal cancer clinical efficacy Surgery RD1-811
Acceso en línea:	https://doaj.org/article/d01551974f574736bd33ee1f48fd1dfd
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spelling	oai:doaj.org-article:d01551974f574736bd33ee1f48fd1dfd2021-12-02T10:31:17ZComparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis2296-875X10.3389/fsurg.2021.752009https://doaj.org/article/d01551974f574736bd33ee1f48fd1dfd2021-12-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fsurg.2021.752009/fullhttps://doaj.org/toc/2296-875XBackground and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.Results: Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], P = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], P = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], P < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], P = 0.02).Conclusions: The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.Jie ZhangJie ZhangXingshun QiFangfang YiFangfang YiRongrong CaoRongrong CaoGuangrong GaoCheng ZhangFrontiers Media S.A.articleda Vinci robotintersphincteric resectionlaparoscopelow rectal cancerclinical efficacySurgeryRD1-811ENFrontiers in Surgery, Vol 8 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	da Vinci robot intersphincteric resection laparoscope low rectal cancer clinical efficacy Surgery RD1-811
spellingShingle	da Vinci robot intersphincteric resection laparoscope low rectal cancer clinical efficacy Surgery RD1-811 Jie Zhang Jie Zhang Xingshun Qi Fangfang Yi Fangfang Yi Rongrong Cao Rongrong Cao Guangrong Gao Cheng Zhang Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis
description	Background and Aims: The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.Methods: PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.Results: Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], P = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], P = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], P < 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], P = 0.02).Conclusions: The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.
format	article
author	Jie Zhang Jie Zhang Xingshun Qi Fangfang Yi Fangfang Yi Rongrong Cao Rongrong Cao Guangrong Gao Cheng Zhang
author_facet	Jie Zhang Jie Zhang Xingshun Qi Fangfang Yi Fangfang Yi Rongrong Cao Rongrong Cao Guangrong Gao Cheng Zhang
author_sort	Jie Zhang
title	Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis
title_short	Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis
title_full	Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis
title_fullStr	Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis
title_full_unstemmed	Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis
title_sort	comparison of clinical efficacy and safety between da vinci robotic and laparoscopic intersphincteric resection for low rectal cancer: a meta-analysis
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/d01551974f574736bd33ee1f48fd1dfd
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Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

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