[Clinical safety and effectiveness of robotic surgery (2)]
Park DA, Yoon JE, Lee NR, Son SK, Lim SW, Lee MJ, Lee SH, Kim JH, Lee DH
Record ID 32015001114
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: 2014
URL for published report: http://www.neca.re.kr/center/paper/report_view.jsp?boardNo=GA&seq=151&q=626f6172644e6f3d4741
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: firstname.lastname@example.org
Contact Email: email@example.com
Copyright: National Evidence-based Healthcare Collaborating Agency (NECA)
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