Evidence map›Paper›PMID 33155975›Full record

SynthesisCanadian journal of surgery. Journal canadien de chirurgie

Robot-assisted coronary artery bypass surgery: a systematic review and meta-analysis of comparative studies.

Fadi Hammal, Fernanda Nagase, Devidas Menon, Imtiaz Ali, Jeevan Nagendran, Tania Stafinski

Open access · diamondAbstract readComparative StudyMeta-AnalysisSystematic Review
In one paragraph

Synthesis in Canadian journal of surgery. Journal canadien de chirurgie. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 15 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
15citing papers in PubMed, 1 pooled it
2.7field-weighted citation impact, top 9% of its field
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, 1 synthesis or guideline pooled it, 22 citations in OpenAlex.

  1. Pooled it
  2. Review
  3. Article
  4. Observational
  5. Review
  6. Article
  7. Article
  8. Article
  9. Article
  10. Review
  11. Minimal-Access Coronary Revascularization: Past, Present, and Future.Journal of cardiovascular development and disease · 2023
    Review
  12. Review
  13. Article
  14. Minimally invasive surgery or stenting for left anterior descending artery disease -International journal of cardiology. Heart & vasculature · 2022
    Review
  15. Commentary: When will the robots come marching in?Journal of cardiac surgery · 2021
    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

6 authors at 3 institutions in 1 country.

Fadi HammalFrom the Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB (Hammal, Nagase, Menon, Stafinski); the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB (Ali); and the Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta HeartInstitute, University of Alberta, Edmonton, AB (Nagendran).
Fernanda NagaseFrom the Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB (Hammal, Nagase, Menon, Stafinski); the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB (Ali); and the Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta HeartInstitute, University of Alberta, Edmonton, AB (Nagendran).
Devidas MenonFrom the Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB (Hammal, Nagase, Menon, Stafinski); the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB (Ali); and the Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta HeartInstitute, University of Alberta, Edmonton, AB (Nagendran).
Imtiaz AliFrom the Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB (Hammal, Nagase, Menon, Stafinski); the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB (Ali); and the Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta HeartInstitute, University of Alberta, Edmonton, AB (Nagendran).
Jeevan NagendranFrom the Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB (Hammal, Nagase, Menon, Stafinski); the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB (Ali); and the Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta HeartInstitute, University of Alberta, Edmonton, AB (Nagendran).
Tania StafinskiFrom the Health Technology & Policy Unit, School of Public Health, University of Alberta, Edmonton, AB (Hammal, Nagase, Menon, Stafinski); the Section of Cardiac Surgery, Department of Cardiac Sciences, Libin Cardiovascular Institute of Alberta, Cumming School of Medicine, University of Calgary, Calgary, AB (Ali); and the Division of Cardiac Surgery, Department of Surgery, Mazankowski Alberta HeartInstitute, University of Alberta, Edmonton, AB (Nagendran).
University of Alberta · CAUniversity of Calgary · CALibin Cardiovascular Institute of Alberta · CA

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRobot-assisted coronary bypass (RCAB) surgery has been proposed as an alternative to conventional coronary artery bypass grafting (C-CABG) for managing coronary heart disease, but the evidence on its performance compared to other existing treatments is unclear. The aim of this study was to assess, through a systematic review of comparative studies, the safety and clinical effectiveness of RCAB compared to C-CABG and other minimally invasive approaches for the treatment of coronary heart disease.

methodsWe conducted a systematic review of primary studies in the English-language literature comparing RCAB to existing treatment options (C-CABG, minimally invasive direct coronary artery bypass [MIDCAB] and port-access coronary artery bypass [PA-CAB]) following Cochrane Collaboration guidelines. Meta-analyses were performed where appropriate.

resultsWe reviewed 13 studies: 11 primary studies of RCAB (v. C-CABG in 7, v. MIDCAB in 3 and v. PA-CAB in 1) and 2 multicentre database studies (RCAB v. non-RCAB). The overall quality of the evidence was low. Most studies showed no significant benefit of RCAB over other treatments in a majority of outcome variables. Meta-analyses showed that RCAB had lower rates of pneumonia or wound infection than C-CABG, and shorter intensive care unit length of stay than C-CABG or MIDCAB. Individual studies showed that RCAB had some better outcomes than C-CABG (ventilation time, transfusion, postoperative pain, hospital length of stay) or MIDCAB (transfusion, postoperative pain, time to return to normal activities, physical functioning and hospital length of stay). The review of the database studies showed that RCAB was statistically superior to non-RCAB approaches in postoperative pain, renal failure, transfusion, reoperation for bleeding, stroke and hospital length of stay; however, the difference between the 2 groups in several of these outcomes was small.

conclusionAlthough the findings from this review of comparative studies of RCAB appear promising and suggest that RCAB may offer some benefits to patients, in the absence of randomized controlled trials, these results should be interpreted cautiously.

Indexed as

Blood TransfusionCoronary Artery BypassCoronary DiseaseHumansLength of StayPostoperative PainReoperationRobotic Surgical ProceduresTreatment Outcome

Identifiers

PMID33155975
PMCPMC7747852
OpenAlexW3096183832

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.