拉丁美洲的机器人结直肠手术:手术效果系统回顾。

IF 1.6 4区 医学 Q2 SURGERY Frontiers in Surgery Pub Date : 2024-10-23 eCollection Date: 2024-01-01 DOI:10.3389/fsurg.2024.1480444
Bruno Augusto Alves Martins, Nicolas Avellaneda, Guglielmo Niccolò Piozzi
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引用次数: 0

摘要

背景和目的:机器人结直肠手术方法正迅速受到关注,尤其是在直肠癌切除方面。尽管存在经济障碍,但在整个拉丁美洲,机器人结直肠手术已大量普及。然而,有关术中、术后早期疗效以及肿瘤学和长期疗效的数据还很缺乏。本系统性综述旨在概述拉丁美洲机器人辅助结直肠手术的手术效果:对电子数据库(包括 PubMed、LILACS、Scopus、Cochrane Library 和 Scielo)进行了系统的文献检索,并根据《系统综述和元分析首选报告项目》指南进行了报告。文献检索的主要目标是报告拉丁美洲结直肠机器人手术结果的研究:初步检索共发现 9,694 篇已发表文章。在对标题和摘要进行审查并去除重复内容后,排除了 9,636 篇出版物。对 58 篇文章进行了全面审查,其中 11 项研究符合纳入标准。根据乔安娜-布里格斯研究所(JBI)的《证据综合手册》对研究质量进行了严格评估(偏倚风险评估)。总体而言,研究的整体质量较差。在纳入分析的 11 项研究中,有 10 项涉及术中和术后早期疗效,7 项涉及肿瘤/病理疗效,仅有 1 项涉及长期疗效。十项研究对术中和术后早期疗效进行了评估,共涉及 425 名患者,其中大部分被确诊为结直肠癌。发病率在 0% 到 45.9% 之间,死亡率在 0% 到 2.5% 之间:结论:针对该地区机器人结直肠手术的术中、术后、病理和肿瘤结果的研究很少。毫无疑问,该地区面临着发达国家所没有的独特挑战,包括在建立结构化培训计划和高质量的机器人手术发展中心方面的经济障碍。要评估机器人手术在该地区的实际应用范围及其效果,还需要进一步的研究。系统综述注册:https://www.crd.york.ac.uk/,PROSPERO (CRD42023494112)。
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Robotic colorectal surgery in Latin America: a systematic review on surgical outcomes.

Background and objectives: Robotic approach in colorectal surgery is rapidly gaining interest, particularly in the context of rectal cancer resection. Despite economic barriers, substantial proliferation of robotic colorectal procedures has been observed throughout Latin America. However, there is a lack of data regarding intraoperative and early postoperative outcomes, as well as oncological and long-term results. This systematic review aims to provide an overview of the surgical outcomes of robotic-assisted colorectal approaches across Latin America.

Material and methods: A systematic literature search of electronic databases, including PubMed, LILACS, Scopus, Cochrane Library and Scielo, was performed and reported in line with Preferred Reporting Items for Systematic Reviews and Meta-Analyses guidelines. The main target of the literature search was studies that reported outcomes of colorectal robotic surgery in Latin America.

Results: A total of 9,694 published articles were identified from the initial search. Nine thousand six hundred thirty-six publications were excluded after title and abstract review and removal of duplicates. Fifty-eight articles were thoroughly reviewed, and 11 studies met the inclusion criteria. The critical appraisal of study quality (biases risk assessment) was performed according to the Joanna Briggs Institute (JBI) Manual for Evidence Synthesis. In general, the overall study quality was poor. Of the 11 studies included in the analysis, ten addressed intraoperative and early postoperative outcomes, seven addressed oncological/pathological outcomes, and just one addressed long-term outcomes. Ten studies evaluated intraoperative and early postoperative outcomes, encompassing a total of 425 patients, the majority of whom were diagnosed with colorectal cancer. Morbidity rates exhibited a range between 0% and 45.9%, while mortality ranged from 0% to 2.5%.

Conclusion: Few studies have been published addressing intraoperative, postoperative, pathological, and oncological outcomes of robotic colorectal surgery in this region. Undoubtedly, there are unique challenges not encountered by developed countries, including economic obstacles in establishing structured training programmes and high-quality centres for the development of robotic surgery. Further studies are needed to assess the real extent of robotic surgery in the region and its results.

Systematic review registration: https://www.crd.york.ac.uk/, PROSPERO (CRD42023494112).

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来源期刊
Frontiers in Surgery
Frontiers in Surgery Medicine-Surgery
CiteScore
1.90
自引率
11.10%
发文量
1872
审稿时长
12 weeks
期刊介绍: Evidence of surgical interventions go back to prehistoric times. Since then, the field of surgery has developed into a complex array of specialties and procedures, particularly with the advent of microsurgery, lasers and minimally invasive techniques. The advanced skills now required from surgeons has led to ever increasing specialization, though these still share important fundamental principles. Frontiers in Surgery is the umbrella journal representing the publication interests of all surgical specialties. It is divided into several “Specialty Sections” listed below. All these sections have their own Specialty Chief Editor, Editorial Board and homepage, but all articles carry the citation Frontiers in Surgery. Frontiers in Surgery calls upon medical professionals and scientists from all surgical specialties to publish their experimental and clinical studies in this journal. By assembling all surgical specialties, which nonetheless retain their independence, under the common umbrella of Frontiers in Surgery, a powerful publication venue is created. Since there is often overlap and common ground between the different surgical specialties, assembly of all surgical disciplines into a single journal will foster a collaborative dialogue amongst the surgical community. This means that publications, which are also of interest to other surgical specialties, will reach a wider audience and have greater impact. The aim of this multidisciplinary journal is to create a discussion and knowledge platform of advances and research findings in surgical practice today to continuously improve clinical management of patients and foster innovation in this field.
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