Original Title: 로봇수술의 안전성과 유효성 분석(2)

Authors' recommendations: We conducted the systematic review and meta-analyses to evaluate the clinical safety and effectiveness of robotic surgery compared to conventional laparoscopic or open surgery. In colon cancer, there was no sufficient published evidence to compare between open and robotic surgery. Regarding comparison of laparoscopic and robotic surgery, robotic surgery was associated with favorable results only in functional outcomes such as time to flatus and time to bowel movement. In bladder cancer, robotic surgery showed a lowered risk of major and individual complications including sepsis when compared to open surgery. However, the result of a randomized clinical study was discrepant from that of a cohort study, thereby making it currently impossible to draw a confirmed conclusion. In cervical cancer, compared to open hysterectomy (OH), robotic hysterectomy (RH) showed lower the risk of wound infection, urinary infection, post-op fever, and transfusion, but manifested a higher incidence of vaginal cuff complications. Compared to laparoscopic hysterectomy (LH), RH showed lower the risk of overall complication, and transfusion. The length of stay was shorter with RH compared to LH or OH. Blood loss was significantly reduced with RH compared to OH. In endometrial cancer, the incidence of overall, intra-operative, and post-operative complication was lower with RH compared to LH or OH. Compared to OH, RH showed lower the risk of wound-related complications, ileus/bowel obstruction, fever, readmission, and transfusion, but manifested a higher incidence of vaginal cuff complications. Compared to LH, RH showed lower the risk of conversion, urinary tract injury, and cystotomy. The length of stay was shorter and blood loss was lesser with RH compared to OH or LH. Operative time was significantly reduced with RH compared to OH. In endometrial cancer and cervical cancer, robotic surgery may be safer than conventional surgery. However, considering methodological quality and level of evidence of the included studies, the results should be interpreted with caution. We additionally conducted systematic reviews for five other cancer diseases: 1) adrenal cancer, 2) renal pelvis and ureter cancer, 3) esophageal cancer, 4) lung and bronchial cancer, 5) oral and laryngopharyngeal cancer, but could not make clear conclusion as lack of evidence. In order to assess comparative safety and effectiveness of robotic surgery for these fields, accumulation of evidence should be required.

Project Status: Completed

Year Published: 2015

URL for published report: https://www.neca.re.kr/lay1/program/S1T11C145/report/view.do?seq=156

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: South Korea

Organisation Name: National Evidence-based healthcare Collaborating Agency

Contact Address: National Evidence-based Healthcare Collaborating Agency (NECA), 3~5F Health and Welfare Social Administration B/D, 400 Neungdong-ro, Gwangjin-gu, Seoul, Korea.

Contact Name: int@neca.re.kr

Contact Email: int@neca.re.kr

Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)