Evidence map›Paper›PMID 32556460›Full record

SynthesisInternational journal of colorectal disease2020

Meta-analysis and trial sequential analysis of robotic versus laparoscopic total mesorectal excision in management of rectal cancer.

Mokhtar Eltair, Shahin Hajibandeh, Shahab Hajibandeh, Abdirahaman Nuno, Kadhim Hussein Abdullah, Ahmad Alkaili-Alyamani, Muhammad Imran Aslam, Ashish Sinha, Tushar Agarwal

Abstract readMeta-AnalysisReview
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 5 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 5 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

15 citing papers in PubMed, 5 syntheses or guidelines pooled it.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Article
  7. Review
  8. Review
  9. Article
  10. Article
  11. Robot-assisted versus conventional laparoscopic surgery for rectal cancer.The Cochrane database of systematic reviews · 2024
    Article
  12. Article
  13. Review
  14. Review
  15. Robotic surgery for colorectal cancer.Annals of gastroenterological surgery · 2020
    Review
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

9 authors.

Mokhtar EltairDepartment of Colorectal Surgery, Ealing Hospital, North West London Hospitals NHS Trust, London, UK. mokhtair@hotmail.com.ORCID https://orcid.org/0000-0001-7132-8757
Shahin HajibandehDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Shahab HajibandehDepartment of General Surgery, Glan Clwyd Hospital, Rhyl, Denbighshire, UK.
Abdirahaman NunoDepartment of Colorectal Surgery, Ealing Hospital, North West London Hospitals NHS Trust, London, UK.
Kadhim Hussein AbdullahDepartment of Colorectal Surgery, Ealing Hospital, North West London Hospitals NHS Trust, London, UK.
Ahmad Alkaili-AlyamaniDepartment of General Surgery, Sandwell and West Birmingham Hospitals NHS Trust, Birmingham, UK.
Muhammad Imran AslamDepartment of Colorectal Surgery, Warwick Hospital, South Warwickshire NHS Foundation Trust, Warwickshire, UK.
Ashish SinhaDepartment of Colorectal Surgery, Ealing Hospital, North West London Hospitals NHS Trust, London, UK.
Tushar AgarwalDepartment of Colorectal Surgery, Ealing Hospital, North West London Hospitals NHS Trust, London, UK.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundWe aimed to evaluate comparative outcomes of robotic and laparoscopic total mesorectal excision (TME) in patients with rectal cancer.

methodsWe systematically searched electronic data sources with application of combination of free text and controlled vocabulary search adapted to thesaurus headings, search operators, and limits. Perioperative clinical and short-term oncological outcomes were evaluated. Trial Sequential Analysis of the outcomes was conducted.

resultsNine randomised-controlled trials reporting 1463 patients evaluating outcomes of robotic TME (n = 728) and laparoscopic TME (n = 735) were included. Although the robotic approach was associated with significantly longer operative time (MD 31.64, P = 0.002), it was associated with significantly longer DRM (MD 0.8, P = 0.004) and shorter time to soft diet (MD - 0.50, P = 0.03) compared to the laparoscopic approach. Moreover, there was no significant difference in intraoperative (RR 1.07, P = 0.76)) and postoperative (RR 0.97, P = 0.81) complications, anastomotic leak (RR 0.93, P = 0.69), conversion to open rate (RR 0.46, P = 0.05), blood loss (MD 19.65, P = 0.74), time to first flatus (MD - 0.30, P = 0.37), LARS (RR 0.83, P = 0.41), ileus (RR 0.72, P = 0.39), positive CRM (RR 0.82, P = 0.49), PRM (MD - 0.5, P = 0.55), number of harvested lymph nodes (MD 0.33, P = 0.58), or length of stay (MD - 0.60, P = 0.12) between two groups. The Trial Sequential Analysis demonstrated that the risk of type 1 and type 2 errors was minimal in most outcomes.

conclusionsModerate-quality evidence suggested that robotic and laparoscopic TME may be comparable in terms of clinical and short-term oncological profile but the robotic approach may be associated with longer procedure time. Future high-quality randomised studies are encouraged to compare the functional, long-term oncological, and cost-effectiveness outcomes of both approaches.

Indexed as

LaparoscopyRectal NeoplasmsRobotic Surgical ProceduresAnastomotic LeakHumansTreatment OutcomeLaparoscopicRectal cancerRoboticTotal mesorectal excision

Identifiers

PMID32556460

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.