Evidence map›Paper›PMID 39269481›Full record

SynthesisSurgical endoscopy2024

Robotic-assisted versus laparoscopic-assisted extended mesorectal excision: a comprehensive meta-analysis and systematic review of perioperative and long-term outcomes.

Ahmed Abdelsamad, Mohammed Khaled Mohammed, Aya Sayed Ahmed Said Serour, Ibrahim Khalil, Zeyad M Wesh, Laila Rashidi, Mike Ralf Langenbach, Florian Gebauer, Khaled Ashraf Mohamed

Abstract readSystematic ReviewMeta-AnalysisComparative Study
PubMed Publisher
In one paragraph

Synthesis in Surgical endoscopy, 2024. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
19citing papers in PubMed, 8 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

19 citing papers in PubMed, 8 syntheses or guidelines pooled it.

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  11. Short-term outcomes of laparoscopic-assisted transanalWorld journal of gastrointestinal surgery · 2026
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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

9 authors.

Ahmed AbdelsamadSection Head of Robotic Surgery, Knappschaft Vest-Hospital, 45657, Recklinghausen, Germany. Ahmed6361410@gmail.com.ORCID 0000-0002-5451-4504
Mohammed Khaled MohammedFaculty of Medicine, Cairo University, Cairo, Egypt.
Aya Sayed Ahmed Said SerourFaculty of Medicine, Cairo University, Cairo, Egypt.
Ibrahim KhalilFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Zeyad M WeshFaculty of Medicine, Alexandria University, Alexandria, Egypt.
Laila RashidiColon and Rectal Unit, MultiCare Health System, Seattle, WA, USA.
Mike Ralf LangenbachDepartment of Surgery II, University of Witten/Herdecke, Witten, Germany.
Florian GebauerDepartment of Surgery II, University of Witten/Herdecke, Witten, Germany.
Khaled Ashraf MohamedCairo University, Giza, Egypt.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundConcurrent neoadjuvant chemo-radiation (nCRT) with total mesorectal excision (TME) alone sometimes fails to cure lateral lymph node metastasis (LLNM). Therefore, additional lateral lymph node dissection (LLND) can help in the treatment of these patients. This is what we refer to as extended total mesorectal excision (eTME). Such operations (TME alone or eTME) can be performed using conventional laparoscopic techniques and robotic-assisted techniques as well. Our meta-analysis aims to compare the results of robot-assisted (R-eTME) versus laparoscopic-assisted extended mesorectal excision (L-eTME) in terms of short- and long-term outcomes. METHODOLOGY: Databases searched using title and abstract included Medline (via PubMed), Web of Science, Scopus, and Embase, up to February 20, 2024. All studies that documented robotic versus laparoscopic procedures for extended total mesorectal excision (R-eTME versus L-eTME) and reported more than two relevant outcomes, were included in the study.

resultsOur meta-analysis demonstrates four significant outcomes (operative time, urinary complications, overall recurrence, and admission days) between the laparoscopic and robotic groups. The robotic approach shows advantages over the laparoscopic approach in these outcomes except for the operative time (minute), which was longer in the robotic group compared to the laparoscopic group. The laparoscopic group is associated with a higher overall recurrence than the robotic group with an Odds Ratio of 2(95% CI, 1-4, p = 0.05).

conclusionThis meta-analysis study showed that the R-eTME group had a lower recurrence rate compared to the L-eTME group. Additionally, hospital admission days increased significantly in the laparoscopic group. Other long-term outcomes did not differ significantly between the two groups. Short-term outcomes were similar, except for more urinary complications in the laparoscopic group. In conclusion, the study suggests that robotic surgery may offer advantages over laparoscopic surgery for eTME. Further research and analysis could provide further insight into the potential benefits of robotic surgery in this procedure, particularly when surgeon experience, center volume, and learning curve are taken into consideration.

Indexed as

LaparoscopyRectal NeoplasmsRobotic Surgical ProceduresHumansLymph Node ExcisionOperative TimePostoperative ComplicationsRectumTreatment OutcomeeTMEExtended mesorectal excisionLaparoscopic surgeryRectal cancerRobotic-assisted surgery

Identifiers

PMID39269481

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.