Evidence map›Paper›PMID 38942946›Full record

ArticleSurgical endoscopy2024

Outcomes comparison of robotic-assisted versus laparoscopic and open surgery for patients undergoing rectal cancer resection with concurrent stoma creation.

Robert N Goldstone, Todd Francone, Gediwon Milky, I-Fan Shih, Hannah Bossie, Yanli Li, Rocco Ricciardi

Abstract readComparative Study
In one paragraph

Article in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–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

2 citing papers in PubMed.

  1. Review
  2. 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

7 authors.

Robert N GoldstoneDepartment of Gastrointestinal and Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street WACC 460, Boston, MA, 02114, USA. rgoldstone@mgb.org.
Todd FranconeDepartment of Gastrointestinal and Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street WACC 460, Boston, MA, 02114, USA.
Gediwon MilkyIntuitive Surgical, Sunnyvale, CA, USA.
I-Fan ShihIntuitive Surgical, Sunnyvale, CA, USA.
Hannah BossieIntuitive Surgical, Sunnyvale, CA, USA.
Yanli LiIntuitive Surgical, Sunnyvale, CA, USA.
Rocco RicciardiDepartment of Gastrointestinal and Surgical Oncology, Massachusetts General Hospital, Harvard Medical School, 15 Parkman Street WACC 460, Boston, MA, 02114, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundDespite widespread adoption of robotic-assisted surgery (RAS) in rectal cancer resection, there remains limited knowledge of its clinical advantage over laparoscopic (Lap) and open (OS) surgery. We aimed to compare clinical outcomes of RAS with Lap and OS for rectal cancer.

methodsWe identified all patients aged ≥ 18 years who had elective rectal cancer resection requiring temporary or permanent stoma formation from 1/2013 to 12/2020 from the PINC AI™ Healthcare Database. We completed multivariable logistic regression analysis accounting for hospital clustering to compare ileostomy formation between surgical approaches. Next, we built inverse probability of treatment-weighted analyses to compare outcomes for ileostomy and permanent colostomy separately. Outcomes included postoperative complications, in-hospital mortality, discharge to home, reoperation, and 30-day readmission.

resultsA total of 12,787 patients (OS: 5599 [43.8%]; Lap: 2872 [22.5%]; RAS: 4316 [33.7%]) underwent elective rectal cancer resection. Compared to OS, patients who had Lap (OR 1.29, p < 0.001) or RAS (OR 1.53, p < 0.001) were more likely to have an ileostomy rather than permanent colostomy. In those with ileostomy, RAS was associated with fewer ileus (OR 0.71, p < 0.001) and less bleeding (OR 0.50, p < 0.001) compared to Lap. In addition, RAS was associated with lower anastomotic leak (OR 0.25, p < 0.001), less bleeding (OR 0.51, p < 0.001), and fewer blood transfusions (OR 0.70, p = 0.022) when compared to OS. In those patients who had permanent colostomy formation, RAS was associated with fewer ileus (OR 0.72, p < 0.001), less bleeding (OR 0.78, p = 0.021), lower 30-day reoperation (OR 0.49, p < 0.001), and higher discharge to home (OR 1.26, p = 0.013) than Lap, as well as OS.

conclusionRectal cancer patients treated with RAS were more likely to have an ileostomy rather than a permanent colostomy and more enhanced recovery compared to Lap and OS.

Indexed as

IleostomyLaparoscopyPostoperative ComplicationsRectal NeoplasmsRobotic Surgical ProceduresAdultAgedColostomyFemaleHospital MortalityHumansMaleMiddle AgedPatient ReadmissionProctectomyReoperationColostomyIleostomyProctectomyRectal cancerRobotic surgery

Identifiers

PMID38942946
PMCPMC11289169

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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.