| The aim of this meta-analysis was to provide recommendations for clinical practice and prevention of post-operative complications,such as the circumferential resection margin involved,amount of intra-operative bleeding,safety,operative time,recovery,outcomes,and clinical significance of robot-assisted versus conventional laparoscopic procedures in anus-preserving rectal cancer.MethodsA search engine(PubMed)was performed to provide biomedical research papers and abstracts for studies comparing robot-assisted and conventional laparoscopic procedures.We attempted to obtain the full text link for papers published between 2000 and 2016,and hand-search references for relevant literature.RevMan 5.3 software was used for the meta-analysis.ResultsThere were nine papers(949 patients),473 patients in the robot group(49.8%),and 476 patients in the laparoscope group(50.2%).According to the data provided in the literature,seven indicators were used to complete the evaluation.The results of the meta-analysis suggested that robot-assisted procedure were associated with lower intra-operative blood loss(MD-41.15;95% CI-77.51,-4.79;P =0.03),lower open conversion rate(RD-0.05,95% CI-0.09,-0.01;P =0.02),lower hospital stay(MD-1.07,95% CI-1.80,-0.33;P =0.005),lower overall complication rate(OR 0.58;95% CI 0.41,0.83;P =0.003),and longer operative time(MD 33.73;95% CI 8.48,58.99;P = 0.009)compared with conventional laparoscopy.There were no differences in the rate of circumferential margin resection involvement(RD-0.02;95% CI-0.05,0.01;P =0.23)and days to return of bowel function(MD-0.03;95% CI-0.40,0.34;P = 0.89).The Da Vinci robot was superior to laparoscopy with respect to blood loss,open conversion,hospital stay,and post-operative complications during anus-preserving rectal cancer procedures;however,conventional laparoscopy had an advantage regarding operative time.The remaining indicators(circumferential resection margins,and recovery from intestinal peristalsis)did not differ. |
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