The efficacy and safety of robot-assisted surgery in cancer patients: a systematic review of randomized controlled trials

作者：Kai Yu, Baoqi Zeng, Qingxin Zhou, Feng Sun · 发表于：International Journal of Surgery · 年份：2024 · DOI：10.1097/js9.0000000000002205 · 被引用次数：3 · 研究领域：Endometrial and Cervical Cancer Treatments、Intraperitoneal and Appendiceal Malignancies、Prostate Cancer Diagnosis and Treatment

BACKGROUND: The utilization of robot-assisted surgery (RAS) has been increasing among cancer patients. However, evidence supporting the use of RAS remains uncertain. The availability of randomized controlled trials (RCTs) for each surgical procedure is limited. This study aimed to assess the safety and efficacy of RAS in cancer patients. MATERIALS AND METHODS: A comprehensive search was performed in Embase, PubMed, the Cochrane Library, and ClinicalTrials.gov from the inception of the databases until 1 April 2023. We included RCTs of RAS in cancer patients compared with laparoscopic, thoracoscopic, or open surgery, and random-effects meta-analyses were performed. RESULTS: A total of 32 trials (6092 patients) met the eligibility criteria. Among these, 22 trials had a low risk of bias, seven trials had some concerns, and three trials were at high risk. Most trials were conducted for bladder cancer ( n = 8), rectal cancer ( n = 5), prostate cancer ( n = 4), and endometrial cancer (n = 4). In all cancers, RAS likely resulted in a slight reduction in the length of hospital stay (31 comparisons; mean difference [MD], - 0.91 days; 95% CI, - 1.33 to - 0.49), but resulted in little to no difference in overall survival (11 comparisons; hazard ratio [HR], 0.96; 95% CI, 0.78 to 1.17). Compared with open surgery, RAS was found to reduce estimated blood loss (MD, - 239.1 mL; 95% CI, - 172.0 to - 306.2) and overall complication (relative risk [RR] 0.88; 95% CI, 0.81 to 0.96), but increase t...