机器人辅助直肠癌手术:临床证据快速摘要》。

Q1 Medicine Ontario Health Technology Assessment Series Pub Date : 2024-04-08 eCollection Date: 2024-01-01
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引用次数: 0

摘要

背景:直肠癌是一种癌细胞在直肠内形成的疾病,直肠的主要功能是暂时储存粪便、控制排便和保持大小便通畅。手术是直肠癌最常见的治疗方法;手术方法包括开腹、腹腔镜和机器人辅助手术。我们对机器人辅助手术治疗直肠癌的临床证据进行了快速总结,其中包括有效性和安全性评估:我们对临床证据进行了系统的文献检索,检索了系统综述和随机对照试验(RCT)。我们使用 AMSTAR 2(评估系统性综述的测量工具,第 2 版)评估了纳入的系统性综述的偏倚风险,并使用 Cochrane Risk-of-Bias Tool for Randomized Trials,第 1 版评估了纳入的 RCT 的偏倚风险。如果对纳入的系统性综述中的证据进行了评估,我们将根据推荐、评估、发展和评价分级(GRADE)工作组的标准对证据的质量进行报告:我们在临床证据综述中纳入了 14 项研究(12 项系统综述和 1 项 RCT,涉及机器人辅助直肠癌手术与腹腔镜直肠癌手术的对比;1 项系统综述,涉及机器人辅助直肠癌手术与开腹直肠癌手术的对比)。与腹腔镜直肠癌手术相比,机器人辅助直肠癌手术可能会带来相似的总生存率;相似的转院率、输血率和再入院率;减少失血;缩短住院时间;提高生活质量。与开放式直肠癌手术相比,机器人辅助直肠癌手术可获得相似的总生存率、减少失血量和缩短住院时间:与腹腔镜直肠癌手术和开腹直肠癌手术相比,机器人辅助直肠癌手术可能会带来相似或更好的临床效果。
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Robotic-Assisted Surgery for Rectal Cancer: An Expedited Summary of the Clinical Evidence.

Background: Rectal cancer is a disease in which cancer cells form in the rectum, which has the primary function of temporarily storing feces, controlling defecation, and maintaining continence. Surgery is the most common treatment for rectal cancer; surgical approaches include open, laparoscopic, and robotic assisted. We conducted an expedited summary of the clinical evidence for robotic-assisted surgery for rectal cancer, which included an evaluation of effectiveness and safety.

Methods: We performed a systematic literature search of the clinical evidence to retrieve systematic reviews and randomized controlled trials (RCTs). We assessed the risk of bias in the included systematic reviews using AMSTAR 2 (A Measurement Tool to Assess Systematic Reviews, version 2), and we assessed the risk of bias in the included RCT using the Cochrane Risk-of-Bias Tool for Randomized Trials, version 1. We reported the quality of the body of evidence as evaluated in the included systematic reviews according to the Grading of Recommendations, Assessment, Development, and Evaluation (GRADE) Working Group criteria if it was evaluated.

Results: We included 14 studies in the clinical evidence review (12 systematic reviews and 1 RCT on robotic-assisted vs. laparoscopic rectal cancer surgery and 1 systematic review on robotic-assisted vs. open rectal cancer surgery). Compared with laparoscopic rectal cancer surgery, robotic-assisted rectal cancer surgery may result in similar overall survival; similar rates of conversion, blood transfusion, and readmission,· reduced blood loss; shorter length of stay; and improved quality of life. Compared with open rectal cancer surgery, robotic-assisted rectal cancer surgery may result in similar overall survival, reduced blood loss, and shorter length of stay.

Conclusions: Robotic-assisted rectal cancer surgery may result in similar or improved clinical outcomes compared with laparoscopic and open rectal cancer surgery.

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来源期刊
Ontario Health Technology Assessment Series
Ontario Health Technology Assessment Series Medicine-Medicine (miscellaneous)
CiteScore
4.60
自引率
0.00%
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0
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