Robotic <i>vs</i> laparoscopic abdominoperineal resection for rectal cancer: A propensity score matching cohort study and meta-analysis

作者全名：Song, Li; Xu, Wen-Qiong; Wei, Zheng-Qiang; Tang, Gang

作者地址：[Song, Li] Chengdu Fifth Peoples Hosp, Dept Gastrointestinal Surg, Chengdu 610000, Sichuan, Peoples R China; [Xu, Wen-Qiong] Chengdu Fifth Peoples Hosp, Dept Nephrol, Chengdu 610000, Sichuan, Peoples R China; [Wei, Zheng-Qiang] Chongqing Med Univ, Affiliated Hosp 1, Dept Gastrointestinal Surg, Chongqing 400000, Peoples R China; [Tang, Gang] Sichuan Univ, West China Hosp, Dept Gen Surg, Div Biliary Tract Surg, 37 Guo Xue Xiang, Chengdu 610041, Sichuan, Peoples R China

通信作者：Tang, G (通讯作者)，Sichuan Univ, West China Hosp, Dept Gen Surg, Div Biliary Tract Surg, 37 Guo Xue Xiang, Chengdu 610041, Sichuan, Peoples R China.

来源：WORLD JOURNAL OF GASTROINTESTINAL SURGERY

ESI学科分类：CLINICAL MEDICINE

WOS号：WOS:001237308800008

JCR分区：Q2

影响因子：1.8

年份：2024

卷号：16

期号：5

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结束页：　

文献类型：Article

关键词：Robotic surgery; Laparoscopic surgery; Abdominoperineal resection; Postoperative complications; Propensity score

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 was no 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.

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