Evidence map›Paper›PMID 33611619›Full record

SynthesisInternational journal of colorectal disease2021

Robotic versus laparoscopic ileal pouch-anal anastomosis (IPAA): a systematic review and meta-analysis.

Julie Flynn, Jose T Larach, Joseph C H Kong, Satish K Warrier, Alexander Heriot

Abstract readMeta-AnalysisSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 37 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
37citing papers in PubMed, 8 pooled it
4.6field-weighted citation impact, top 3% 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

37 citing papers in PubMed, 8 syntheses or guidelines pooled it, 68 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Pooled it
  7. Pooled it
  8. Pooled it
  9. Article
  10. Article
  11. Article
  12. Review
  13. Review
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Review
  20. Article
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

5 authors at 3 institutions in 2 countries.

Julie Flynn *Department of Surgery, Epworth Healthcare, Bridge Rd, Richmond, 3121, Australia. Jafly1@gmail.com.ORCID http://orcid.org/0000-0003-3090-9090
Jose T Larach *Department of Surgery, Epworth Healthcare, Bridge Rd, Richmond, 3121, Australia.ORCID https://orcid.org/0000-0001-5242-9456
Joseph C H KongDivision of Cancer Surgery, University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia.ORCID https://orcid.org/0000-0002-1392-2480
Satish K WarrierDivision of Cancer Surgery, University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia.
Alexander HeriotDivision of Cancer Surgery, University of Melbourne, Sir Peter MacCallum Cancer Centre, Melbourne, Australia.ORCID https://orcid.org/0000-0001-9846-8776
The University of Melbourne · AUEpworth Hospital · AUPontificia Universidad Católica de Chile · CL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundRestorative proctocolectomy with ileal-pouch anal anastomosis (IPAA) is a curative and cancer preventative procedure in patients with ulcerative colitis (UC) and familial adenomatous polyposis (FAP). It can be technically difficult laparoscopically, and hence the robotic platform has been suggested as a way to enable minimally invasive surgery in more patients. This systematic review examines robotic proctectomy or proctocolectomy with IPAA. A limited meta-analysis was performed on data comparing the robotic approach to laparoscopy.

methodsWe searched MEDLINE, EMBASE and the Cochrane database for case series of robotic IPAA procedures and studies comparing the robotic to laparoscopic or open procedures. Data examined includes operating time, conversion to open, length of stay, complications, blood loss, return of bowel function, reoperation rate and functional outcomes.

resultsFive non-randomised studies compared robotic to laparoscopic techniques; one compared robotic to open surgery and three case series are included. Operating time was significantly longer in robotic cases. Estimated blood loss was significantly less in three of four studies which reported this; hospital stay was significantly less in two. There were nonsignificant reductions in complications and readmission rates. Pooled analysis of four papers with adequate data showed a nonstatistically significant trend to less complications in robotic procedures. Three studies assessed functional and quality of life outcomes, with little difference between the platforms.

conclusionsAvailable data suggests that the robotic platform is safe to use for IPAA procedures. There is minimal evidence for clinical advantages, but with little data to base decisions and significant potential for improvements in technique and cost-effectiveness, further use of the platform for this operation is warranted. It is vital that this occurs within an evaluation framework.

Indexed as

Colitis, UlcerativeColonic PouchesLaparoscopyProctocolectomy, RestorativeRobotic Surgical ProceduresAnastomosis, SurgicalHumansPostoperative ComplicationsQuality of LifeRetrospective StudiesTreatment OutcomeColorectal surgeryIleal pouch-anal anastomosisRestorative proctocolectomyRobotic surgery

Identifiers

PMID33611619
OpenAlexW3133300619

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.