Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis
Identifieur interne : 000087 ( Main/Merge ); précédent : 000086; suivant : 000088Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis
Auteurs : Yanlai Sun [République populaire de Chine] ; Huirong Xu [République populaire de Chine] ; Zengjun Li [République populaire de Chine] ; Jianjun Han [République populaire de Chine] ; Wentao Song [République populaire de Chine] ; Junwei Wang [République populaire de Chine] ; Zhongfa Xu [République populaire de Chine]Source :
- World Journal of Surgical Oncology [ 1477-7819 ] ; 2016.
Abstract
The objective of this meta-analysis was to compare the clinical and oncologic outcomes of robotic low anterior resection (R-LAR) with conventional laparoscopic low anterior resection (L-LAR).
A search in the MEDLINE, Embase, and Ovid databases was performed for studies published before July 2014 that compared the clinical and oncologic outcomes of R-LAR and L-LAR. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, a fixed or random effects model was used for the meta-analysis. The clinical and oncologic outcomes evaluated included operative time, estimated blood loss, length of hospital stay, rate of conversion to open surgery, post-operative complications, circumferential margin status, and number of lymph nodes collected.
Eight studies, including 324 R-LAR cases and 268 conventional L-LAR cases, were analyzed. The meta-analysis showed that R-LAR was associated with a shorter hospital stay (mean difference (MD) = −1.03; 95 % confidence interval (CI) = −1.78, −0.28;
R-LAR was shown to be associated with a shorter hospital stay, lower conversion rate, lower rate of circumferential margin involvement, and lower overall complication rate compared with L-LAR. There were no differences in operative time, the number of lymph nodes removed, and days to return of bowel function.
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DOI: 10.1186/s12957-016-0816-6
PubMed: 26928124
PubMed Central: 4772524
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<record><TEI><teiHeader><fileDesc><titleStmt><title xml:lang="en">Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis</title><author><name sortKey="Sun, Yanlai" sort="Sun, Yanlai" uniqKey="Sun Y" first="Yanlai" last="Sun">Yanlai Sun</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Xu, Huirong" sort="Xu, Huirong" uniqKey="Xu H" first="Huirong" last="Xu">Huirong Xu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Li, Zengjun" sort="Li, Zengjun" uniqKey="Li Z" first="Zengjun" last="Li">Zengjun Li</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Han, Jianjun" sort="Han, Jianjun" uniqKey="Han J" first="Jianjun" last="Han">Jianjun Han</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Song, Wentao" sort="Song, Wentao" uniqKey="Song W" first="Wentao" last="Song">Wentao Song</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Junwei" sort="Wang, Junwei" uniqKey="Wang J" first="Junwei" last="Wang">Junwei Wang</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Xu, Zhongfa" sort="Xu, Zhongfa" uniqKey="Xu Z" first="Zhongfa" last="Xu">Zhongfa Xu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author></titleStmt><publicationStmt><idno type="wicri:source">PMC</idno><idno type="pmid">26928124</idno><idno type="pmc">4772524</idno><idno type="url">http://www.ncbi.nlm.nih.gov/pmc/articles/PMC4772524</idno><idno type="RBID">PMC:4772524</idno><idno type="doi">10.1186/s12957-016-0816-6</idno><date when="2016">2016</date><idno type="wicri:Area/Pmc/Corpus">000896</idno><idno type="wicri:Area/Pmc/Curation">000896</idno><idno type="wicri:Area/Pmc/Checkpoint">000050</idno><idno type="wicri:Area/Ncbi/Merge">004015</idno><idno type="wicri:Area/Ncbi/Curation">004015</idno><idno type="wicri:Area/Ncbi/Checkpoint">004015</idno><idno type="wicri:Area/Main/Merge">000087</idno></publicationStmt><sourceDesc><biblStruct><analytic><title xml:lang="en" level="a" type="main">Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis</title><author><name sortKey="Sun, Yanlai" sort="Sun, Yanlai" uniqKey="Sun Y" first="Yanlai" last="Sun">Yanlai Sun</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Xu, Huirong" sort="Xu, Huirong" uniqKey="Xu H" first="Huirong" last="Xu">Huirong Xu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Li, Zengjun" sort="Li, Zengjun" uniqKey="Li Z" first="Zengjun" last="Li">Zengjun Li</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Han, Jianjun" sort="Han, Jianjun" uniqKey="Han J" first="Jianjun" last="Han">Jianjun Han</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Song, Wentao" sort="Song, Wentao" uniqKey="Song W" first="Wentao" last="Song">Wentao Song</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Wang, Junwei" sort="Wang, Junwei" uniqKey="Wang J" first="Junwei" last="Wang">Junwei Wang</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author><author><name sortKey="Xu, Zhongfa" sort="Xu, Zhongfa" uniqKey="Xu Z" first="Zhongfa" last="Xu">Zhongfa Xu</name><affiliation wicri:level="1"><nlm:aff id="Aff1">Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117 China</nlm:aff><country xml:lang="fr">République populaire de Chine</country><wicri:regionArea>Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan</wicri:regionArea><wicri:noRegion>Jinan</wicri:noRegion></affiliation></author></analytic><series><title level="j">World Journal of Surgical Oncology</title><idno type="eISSN">1477-7819</idno><imprint><date when="2016">2016</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><sec><title>Background</title><p>The objective of this meta-analysis was to compare the clinical and oncologic outcomes of robotic low anterior resection (R-LAR) with conventional laparoscopic low anterior resection (L-LAR).</p></sec><sec><title>Methods</title><p>A search in the MEDLINE, Embase, and Ovid databases was performed for studies published before July 2014 that compared the clinical and oncologic outcomes of R-LAR and L-LAR. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, a fixed or random effects model was used for the meta-analysis. The clinical and oncologic outcomes evaluated included operative time, estimated blood loss, length of hospital stay, rate of conversion to open surgery, post-operative complications, circumferential margin status, and number of lymph nodes collected.</p></sec><sec><title>Results</title><p>Eight studies, including 324 R-LAR cases and 268 conventional L-LAR cases, were analyzed. The meta-analysis showed that R-LAR was associated with a shorter hospital stay (mean difference (MD) = −1.03; 95 % confidence interval (CI) = −1.78, −0.28; <italic>P</italic> = 0.007), lower conversion rate (odds ratio (OR) = 0.08; 95 % CI = 0.02, 0.31; <italic>P</italic> = 0.0002), lower rate of circumferential margin involvement (OR = 0.5; 95 % CI = 0.25, 1.01; <italic>P</italic> = 0.05), and lower overall complication rate (MD = 0.65; 95 % CI = 0.43, 0.99; <italic>P</italic> = 0.04) compared with L-LAR. There was no difference in operative time (MD = 28.4; 95 % CI = −3.48, 60.27; <italic>P</italic> = 0.08), the number of lymph nodes removed (MD = −0.63; 95 % CI = −0.78, 2.05; <italic>P</italic> = 0.38), and days to return of bowel function (MD = −0.15; 95 % CI = −0.37, 0.06; <italic>P</italic> = 0.17).</p></sec><sec><title>Conclusions</title><p>R-LAR was shown to be associated with a shorter hospital stay, lower conversion rate, lower rate of circumferential margin involvement, and lower overall complication rate compared with L-LAR. 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Kim</name></author><author><name sortKey="Woo, Su" uniqKey="Woo S">SU Woo</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kim, Nk" uniqKey="Kim N">NK Kim</name></author><author><name sortKey="Kang, J" uniqKey="Kang J">J Kang</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Kwak, Jm" uniqKey="Kwak J">JM Kwak</name></author><author><name sortKey="Kim, Sh" uniqKey="Kim S">SH Kim</name></author><author><name sortKey="Kim, J" uniqKey="Kim J">J Kim</name></author><author><name sortKey="Son, Dn" uniqKey="Son D">DN Son</name></author><author><name sortKey="Baek, Sj" uniqKey="Baek S">SJ Baek</name></author><author><name sortKey="Cho, Js" uniqKey="Cho J">JS Cho</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Patriti, A" uniqKey="Patriti A">A Patriti</name></author><author><name sortKey="Ceccarelli, G" uniqKey="Ceccarelli G">G Ceccarelli</name></author><author><name sortKey="Bartoli, A" uniqKey="Bartoli A">A Bartoli</name></author><author><name sortKey="Spaziani, A" uniqKey="Spaziani A">A Spaziani</name></author><author><name sortKey="Biancafarina, A" uniqKey="Biancafarina A">A Biancafarina</name></author><author><name sortKey="Casciola, L" uniqKey="Casciola L">L Casciola</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Broholm, M" uniqKey="Broholm M">M Broholm</name></author><author><name sortKey="Pommergaard, Hc" uniqKey="Pommergaard H">HC Pommergaard</name></author><author><name sortKey="Gogenur, I" uniqKey="Gogenur I">I Gögenür</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Rencuzogullari, A" uniqKey="Rencuzogullari A">A Rencuzogullari</name></author><author><name sortKey="Gorgun, E" uniqKey="Gorgun E">E Gorgun</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="D Nnibale, A" uniqKey="D Nnibale A">A D’Annibale</name></author><author><name sortKey="Pernazza, G" uniqKey="Pernazza G">G Pernazza</name></author><author><name sortKey="Morpurgo, E" uniqKey="Morpurgo E">E Morpurgo</name></author><author><name sortKey="Monsellato, I" uniqKey="Monsellato I">I Monsellato</name></author><author><name sortKey="Pende, V" uniqKey="Pende V">V Pende</name></author><author><name sortKey="Lucandri, G" uniqKey="Lucandri G">G Lucandri</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Nagtegaal, Id" uniqKey="Nagtegaal I">ID Nagtegaal</name></author><author><name sortKey="Quirke, P" uniqKey="Quirke P">P Quirke</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Hottenrott, C" uniqKey="Hottenrott C">C Hottenrott</name></author></analytic></biblStruct><biblStruct><analytic><author><name sortKey="Maclehose, Rr" uniqKey="Maclehose R">RR MacLehose</name></author><author><name sortKey="Reeves, Bc" uniqKey="Reeves B">BC Reeves</name></author><author><name sortKey="Harvey, Im" uniqKey="Harvey I">IM Harvey</name></author><author><name sortKey="Sheldon, Ta" uniqKey="Sheldon T">TA Sheldon</name></author><author><name sortKey="Russell, It" uniqKey="Russell I">IT Russell</name></author><author><name sortKey="Black, Am" uniqKey="Black A">AM Black</name></author></analytic></biblStruct></listBibl></div1></back></TEI></record>Pour manipuler ce document sous Unix (Dilib)
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