Evidence map›Paper›PMID 30623315›Full record

SynthesisTechniques in coloproctology2019

Laparoscopic vs. robotic rectal cancer surgery and the effect on conversion rates: a meta-analysis of randomized controlled trials and propensity-score-matched studies.

K Phan, H R Kahlaee, S H Kim, J W T Toh

Abstract readComparative StudyMeta-Analysis
PubMed Publisher
In one paragraph

Synthesis in Techniques in coloproctology, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 50 papers, 11 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
50citing papers in PubMed, 11 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

50 citing papers in PubMed, 11 syntheses or guidelines pooled it.

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  11. Simultaneous Robot Assisted Colon and Liver Resection for Metastatic Colon Cancer.JSLS : Journal of the Society of Laparoendoscopic Surgeons
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4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

4 authors.

K PhanDivision of Colorectal Surgery, Department of Surgery, Westmead Hospital, Sydney, NSW, Australia.
H R KahlaeeDepartment of Pharmacy, Faculty of Medicine and Health, The University of Sydney, Sydney, NSW, 2006, Australia.
S H KimDivision of Colorectal Surgery, Department of Surgery, Korea University Anam Hospital, Korea University College of Medicine, 73 Inchon-ro, Seongbuk-gu, Seoul, 02841, South Korea.
J W T TohDivision of Colorectal Surgery, Department of Surgery, Westmead Hospital, Sydney, NSW, Australia. james.toh@sydney.edu.au.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundThe usage of robotic surgery in rectal cancer is increasing, but there is an ongoing debate as to whether it provides any benefit. The aim of the present study was to determine if robotic surgery results in less conversion to an open operation than laparoscopic rectal cancer surgery.

methodsA meta-analysis was performed according to Preferred Reporting Items for Systematic Reviews and Meta-analyses (PRISMA) guidelines using Ovid Medline, PubMed, Cochrane Central Register of Controlled Trials, Cochrane Database of Systematic Reviews, ACP Journal Club and Database of Abstracts of Review of Effectiveness. Included were randomized controlled trials (RCTs) and propensity-score-matched (PSM) studies comparing a robotic vs. laparoscopic approach to rectal cancer surgery. The primary endpoint was conversion to open. All statistical analyses and data synthesis were conducted using STATA/IC version 14·2, Windows 64 bit (StataCorp LP, College Station, TX, USA)

resultsSix hundred and twenty-one studies were identified through electronic database search. After application of selection criteria as per PRISMA and MOOSE criteria, six RCTs and five PSM articles were analyzed. From the six RCTs, 512 robotic and 519 laparoscopic cases were evaluated. There was a significantly lower rate of conversion for the robotic surgery arm (4.1% vs. 8.1%, OR 0.28; 95% CI 0.00-0.57). Of the five PSM studies, 2097 robotic and 3053 laparoscopic cases were evaluated. There was a significantly lower conversion to open rate found in the robotic surgery cohort (7.4% vs. 15.6%; OR 0.39; 95% CI 0.30-0.47). Pooled RCT and PSM data demonstrated significantly lower conversion rates for robotic surgery (6.7% vs. 14.5%; OR 0.38; 95% CI 0.30-0.46).

conclusionsRobotic surgery for rectal cancer is associated with reduced conversion to open surgery compared to a laparoscopic approach.

Indexed as

AdultAgedConversion to Open SurgeryFemaleHumansLaparoscopyMaleMiddle AgedPropensity ScoreRandomized Controlled Trials as TopicRectal NeoplasmsRobotic Surgical ProceduresConversion to open surgeryLaparoscopic surgeryMeta-analysisRectal cancerRECTUM/surgRobotic surgical procedures

Identifiers

PMID30623315

What OpenQuestion holds

Textmetadata
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Registered trials

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.