Abstract：
BACKGROUND: There are few available studies that compare the feasibility, efficacy, and safety of robotic pelvic lateral lymph node dissection compared to laparoscopic pelvic lateral lymph node dissection (LPLND) in advanced rectal cancer. This meta-analysis aims to compare perioperative outcomes between robotic and LPLND.
METHODS: We performed a systemic literature review of PubMed, Embase, and Web of Science databases. Perioperative parameters were extracted and pooled for analysis. This meta-analysis provided an analysis of heterogeneity and prediction intervals.
RESULTS: Five studies were included: 567 patients divided between 266 robotic and 301 LPLND. Overall operation time was longer in the robotic group than laparoscopic group (difference in means = 67.11, 95% CI [30.80, 103.42], p < 0.001) but the difference in the pelvic lateral lymph dissection time was not statistically significant (difference in means = - 1.212, 95% CI [ - 11.594, 9.171], p = 0.819). There were fewer overall complications in the robotic than in the laparoscopic group (OR = 1.589, 95% CI [1.009, 2.503], p = 0.046), especially with respect to urinary retention (OR = 2.23, 95% CI [1.277, 3.894], p = 0.005). More pelvic lateral lymph nodes were harvested by robotic surgery than by laparoscopy (differences in means = - 1.992, 95% CI [ - 2.421, 1.563], p < 0.001).
CONCLUSIONS: In this meta-analysis, robotic pelvic lateral lymph node dissection was associated with more pelvic lateral lymph nodes harvested and lower overall complications, especially urinary retention when compared to LPLND. Further studies are needed to reinforce these findings.
METHODS: We performed a systemic literature review of PubMed, Embase, and Web of Science databases. Perioperative parameters were extracted and pooled for analysis. This meta-analysis provided an analysis of heterogeneity and prediction intervals.
RESULTS: Five studies were included: 567 patients divided between 266 robotic and 301 LPLND. Overall operation time was longer in the robotic group than laparoscopic group (difference in means = 67.11, 95% CI [30.80, 103.42], p < 0.001) but the difference in the pelvic lateral lymph dissection time was not statistically significant (difference in means = - 1.212, 95% CI [ - 11.594, 9.171], p = 0.819). There were fewer overall complications in the robotic than in the laparoscopic group (OR = 1.589, 95% CI [1.009, 2.503], p = 0.046), especially with respect to urinary retention (OR = 2.23, 95% CI [1.277, 3.894], p = 0.005). More pelvic lateral lymph nodes were harvested by robotic surgery than by laparoscopy (differences in means = - 1.992, 95% CI [ - 2.421, 1.563], p < 0.001).
CONCLUSIONS: In this meta-analysis, robotic pelvic lateral lymph node dissection was associated with more pelvic lateral lymph nodes harvested and lower overall complications, especially urinary retention when compared to LPLND. Further studies are needed to reinforce these findings.
摘要：
背景：很少有可用的研究比较可行性，功效,与腹腔镜盆腔外侧淋巴结清扫术（LPLND）相比，机器人盆腔外侧淋巴结清扫术在晚期直肠癌中的安全性。这项荟萃分析旨在比较机器人和LPLND的围手术期结果。
方法：我们对PubMed，Embase,和WebofScience数据库。提取围手术期参数并汇集用于分析。这项荟萃分析提供了异质性和预测间隔的分析。
结果：纳入了5项研究：567名患者分为266名机器人和301名LPLND。机器人组的总体手术时间长于腹腔镜组（均值差异=67.11，95％CI[30.80，103.42]，p<0.001），但盆腔外侧淋巴清扫时间的差异无统计学意义（均值差异=-1.212，95％CI[-11.594，9.171]，p=0.819)。机器人的总体并发症少于腹腔镜组（OR=1.589，95％CI[1.009，2.503]，p=0.046),尤其是关于尿潴留(OR=2.23，95%CI[1.277，3.894]，p=0.005)。机器人手术获取的盆腔外侧淋巴结多于腹腔镜手术（均值差异=-1.992,95%CI[-2.421,1.563]，p<0.001)。
结论：在本荟萃分析中，机器人盆腔外侧淋巴结清扫术与获取更多的盆腔外侧淋巴结和更低的整体并发症相关，与LPLND相比，尤其是尿潴留。需要进一步的研究来加强这些发现。
方法：我们对PubMed，Embase,和WebofScience数据库。提取围手术期参数并汇集用于分析。这项荟萃分析提供了异质性和预测间隔的分析。
结果：纳入了5项研究：567名患者分为266名机器人和301名LPLND。机器人组的总体手术时间长于腹腔镜组（均值差异=67.11，95％CI[30.80，103.42]，p<0.001），但盆腔外侧淋巴清扫时间的差异无统计学意义（均值差异=-1.212，95％CI[-11.594，9.171]，p=0.819)。机器人的总体并发症少于腹腔镜组（OR=1.589，95％CI[1.009，2.503]，p=0.046),尤其是关于尿潴留(OR=2.23，95%CI[1.277，3.894]，p=0.005)。机器人手术获取的盆腔外侧淋巴结多于腹腔镜手术（均值差异=-1.992,95%CI[-2.421,1.563]，p<0.001)。
结论：在本荟萃分析中，机器人盆腔外侧淋巴结清扫术与获取更多的盆腔外侧淋巴结和更低的整体并发症相关，与LPLND相比，尤其是尿潴留。需要进一步的研究来加强这些发现。
