Perioperative pain after robot-assisted versus laparoscopic rectal resection

Tolstrup, Rikke; Funder, Jonas Amstrup; Lundbech, Liselotte B; Thomassen, Niels; Iversen, Lene Hjerrild

doi:10.1007/s00384-017-2943-0

Cited by 31 publications

(16 citation statements)

References 15 publications

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“…Figure 1 showed the process used to select potentially relevant studies for inclusion. Seven RCTs [17][18][19][20][21][22][23] including 1022 cases (505 cases for RRS and 517 cases for LRS) fulfilled the predefined inclusion criteria and were included in the final analysis. Examination of the references listed for these studies and for the review articles did not yield any further studies for evaluation.…”

Section: Discussionmentioning

confidence: 99%

Robotic Versus Laparoscopic Rectal Surgery for Rectal Cancer: A Meta-Analysis of 7 Randomized Controlled Trials

Zhang

Guo

et al. 2019

Surg Innov

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Background. Robotic surgery has been recently used as a novel tool for rectal surgery. This study assessed the current evidence regarding the efficiency, safety, and potential advantages of robotic rectal surgery (RRS) compared with laparoscopic rectal surgery (LRS). Methods. We comprehensively searched PubMed, Embase, and the Cochrane Library databases and performed a systematic review and cumulative meta-analysis of all randomized controlled trials (RCTs) assessing the 2 approaches. Results. Seven RCTs including a total of 1022 cases were identified. The conversion rate is significantly lower for RRS (odds ratio: 0.29; 95% confidence interval: 0.09 to 0.96; P = .04). The length of the distal margin was significantly shorter in the LRS group than in the RRS group (weighted mean difference: 0.60; 95% confidence interval: 0.09 to 1.10; P = .02). Perioperative complication rates, harvested lymph nodes, positive circumferential resection margins, complete total mesorectal excision, first flatus, and length of stay did not differ significantly between approaches ( P > .05). Conclusions. This meta-analysis indicates that RRS is a safe and effective approach. It is not inferior to LRS in terms of oncologic outcomes and postoperative complications. Future large-volume, well-designed RCTs with extensive follow-up are awaited to confirm and update the findings of this analysis.

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Section: Discussionmentioning

confidence: 99%

Robotic Versus Laparoscopic Rectal Surgery for Rectal Cancer: A Meta-Analysis of 7 Randomized Controlled Trials

Zhang

Guo

et al. 2019

Surg Innov

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“…Investigating this theory of a less painful incision, Kelley et al [25] reported a 50% lower use of postoperative narcotics in the robotic group compared to laparoscopic right hemicolectomies. Within the literature specific to rectal procedures, there are no statistically significant differences in postoperative pain scores or analgesic use between the two interventions [18,26] .…”

Section: Painmentioning

confidence: 99%

Robotic or laparoscopic surgery for rectal cancer - which is the best answer? a comprehensive review of non-oncological outcomes and learning curve

Kavalukas¹,

Ghuman²,

Sharp³

et al. 2020

Mini-invasive Surg

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Much effort has been spent evaluating the difference between robotic and laparoscopic surgery platforms for rectal cancer. There is a plethora of literature comparing outcomes for intraoperative events, postoperative complications, long term outcomes, cost, and learning curve. The data are conclusive regarding the higher cost of robotic surgery compared to laparoscopic surgery. This article is a comprehensive review of the available literature regarding intraoperative and postoperative outcomes. For practically all parameters evaluated, there are no significant differences between the two platforms. The ultimate decision on whether to perform robotic vs. laparoscopic surgery should be based on surgeon preference and familiarity with equipment, as well as local resources.

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“…Using only the most recent time point of ‘long‐term follow‐up’ of primary outcomes for a given study population yielded 103 principal studies 14–116 for detailed analysis ( Table S1 , supporting information). There were 99 two‐arm studies (96·1 per cent) and four three‐arm studies (3·9 per cent), with a median of 78 (range 6–1516) patients.…”

Section: Resultsmentioning

confidence: 99%

Research quality and transparency, outcome measurement and evidence for safety and effectiveness in robot-assisted surgery: systematic review

et al. 2020

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Background: Robot-assisted surgery (RAS) has potential panspecialty surgical benefits. High-quality evidence for widespread implementation is lacking. This systematic review aimed to assess the RAS evidence base for the quality of randomized evidence on safety and effectiveness, specialty 'clustering', and outcomes for RAS research. Methods: A systematic review was undertaken according to PRISMA guidelines. All pathologies and procedures utilizing RAS were included. Studies were limited to RCTs, the English language and publication within the last decade. The main outcomes selected for the review design were safety and efficacy, and study purpose. Secondary outcomes were study characteristics, funding and governance. Results: Searches identified 7142 titles, from which 183 RCTs were identified for data extraction. The commonest specialty was urology (35⋅0 per cent). There were just 76 unique study populations, indicating significant overlap of publications; 103 principal studies were assessed further. Only 64⋅1 per cent of studies reported a primary outcome measure, with 29⋅1 per cent matching their registration/protocol. Safety was assessed in 68⋅9 per cent of trials; operative complications were the commonest measure. Forty-eight per cent of trials reported no significant difference in safety between RAS and comparator, and 11 per cent reported RAS to be superior. Efficacy or effectiveness was assessed in 80⋅6 per cent of trials; 43 per cent of trials showed no difference between RAS and comparator, and 24 per cent reported that RAS was superior. Funding was declared in 47⋅6 per cent of trials. Conclusion: The evidence base for RAS is of limited quality and variable transparency in reporting. No patterns of harm to patients were identified. RAS has potential to be beneficial, but requires continued high-quality evaluation.

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Perioperative pain after robot-assisted versus laparoscopic rectal resection

Cited by 31 publications

References 15 publications

Robotic Versus Laparoscopic Rectal Surgery for Rectal Cancer: A Meta-Analysis of 7 Randomized Controlled Trials

Robotic Versus Laparoscopic Rectal Surgery for Rectal Cancer: A Meta-Analysis of 7 Randomized Controlled Trials

Robotic or laparoscopic surgery for rectal cancer - which is the best answer? a comprehensive review of non-oncological outcomes and learning curve

Research quality and transparency, outcome measurement and evidence for safety and effectiveness in robot-assisted surgery: systematic review

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