Robotic vs laparoscopic abdominoperineal resection for rectal cancer:A propensity score matching cohort study and metaanalysis  

作　　者：Li Song Wen-Qiong Xu Zheng-Qiang Wei Gang Tang 

机构地区：[1]Department of Gastrointestinal Surgery,Chengdu Fifth People's Hospital,Chengdu 610000,Sichuan Province,China [2]Department of Nephrology,Chengdu Fifth People's Hospital,Chengdu 610000,Sichuan Province,China [3]Department of Gastrointestinal Surgery,The First Affiliated Hospital of Chongqing Medical University,Chongqing 400000,China [4]Division of Biliary Tract Surgery,Department of General Surgery,West China Hospital,Sichuan University,Chengdu 610041,Sichuan Province,China

出　　处：《World Journal of Gastrointestinal Surgery》2024年第5期1280-1290,共11页世界胃肠外科杂志（英文版）（电子版）

摘　　要：BACKGROUND Robotic surgery(RS)is gaining popularity;however,evidence for abdominoperineal resection(APR)of rectal cancer(RC)is scarce.AIM To compare the efficacy of RS and laparoscopic surgery(LS)in APR for RC.METHODS We retrospectively identified patients with RC who underwent APR by RS or LS from April 2016 to June 2022.Data regarding short-term surgical outcomes were compared between the two groups.To reduce the effect of potential confounding factors,propensity score matching was used,with a 1:1 ratio between the RS and LS groups.A meta-analysis of seven trials was performed to compare the efficacy of robotic and laparoscopic APR for RC surgery.RESULTS Of 133 patients,after propensity score matching,there were 42 patients in each group.The postoperative complication rate was significantly lower in the RS group(17/42,40.5%)than in the LS group(27/42,64.3%)(P=0.029).There wasno significant difference in operative time(P=0.564),intraoperative transfusion(P=0.314),reoperation rate(P=0.314),lymph nodes harvested(P=0.309),or circumferential resection margin(CRM)positive rate(P=0.314)between the two groups.The meta-analysis showed patients in the RS group had fewer positive CRMs(P=0.04),lesser estimated blood loss(P<0.00001),shorter postoperative hospital stays(P=0.02),and fewer postoperative complications(P=0.002)than patients in the LS group.CONCLUSION Our study shows that RS is a safe and effective approach for APR in RC and offers better short-term outcomes than LS.

关 键 词：Robotic surgery Laparoscopic surgery Abdominoperineal resection Postoperative complications Propensity score 

分 类 号：R735.2[医药卫生—肿瘤]