Effects of Robotic Versus Laparoscopic Surgery for Rectal Cancer on Male Urinary Function: a Meta-analysis
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REVIEW ARTICLE
Effects of Robotic Versus Laparoscopic Surgery for Rectal Cancer on Male Urinary Function: a Meta-analysis Hang Li 1 & Ye Zhang 1 & Shuai Wang 1 & Tong Wang 1 Received: 3 July 2020 / Accepted: 29 September 2020 # Association of Surgeons of India 2020
Abstract The purpose of this study was to evaluate whether robotic surgery is superior to laparoscopic surgery for protecting urinary function in male patients with rectal cancer. We systematically searched PubMed, Web of Science Core Collection, Cochrane Library, and Embase databases for relevant articles in April 2020. All articles about the differences between robotic and laparoscopic surgeries for rectal cancer were identified. The patients’ urinary function was assessed using the International Prostate Symptom Score (IPSS). After searching, eight studies with 955 male patients were included. Four hundred sixty-six male patients were included in the robotic group, and 489 male patients were included in the laparoscopic group. Statistical analysis of the IPSS scores indicated that robotic surgery provided better recovery of male urinary function than laparoscopic surgery at 3 and 12 months post-operatively (mean difference(MD), − 1.26; 95% CI, − 2.24 to − 0.07; p = 0.04; and MD, − 1.02; 95% CI, − 1.79 to − 0.25; p = 0.009); there was no significant difference between the two groups at 6 months post-operatively (MD, − 0.76; 95% CI, − 1.73 to 0.21; p = 0.12). Therefore, we concluded that robotic rectal cancer surgery is more effective than laparoscopic rectal cancer surgery in protecting male urinary function. Keywords Robotic surgery . Laparoscopic surgery . Rectal cancer . Male urinary function
Introduction Rectal cancer is one of the most common malignant tumors of the gastrointestinal tract, the global incidence of rectal cancer is continuously increasing each year, and the age distribution is shifting toward younger ages [1, 2]. Surgical resection remains the primary treatment for rectal cancer, and it is the only possible radical treatment for rectal cancer [3, 4]. However, surgery often causes varying degrees of urinary dysfunction, which seriously affect the postoperative quality of recovery and the quality of life among patients [5, 6]. A latest research showed that incidence rate of incontinence and bladder-
Electronic supplementary material The online version of this article (https://doi.org/10.1007/s12262-020-02617-w) contains supplementary material, which is available to authorized users. * Tong Wang [email protected] 1
Department of General Surgery, Nanjing Medical University Affiliated Wuxi people’s Hospital, 299 Qingyang Road, Wuxi, Jiangsu Province, China
emptying difficulties were 20% and 46%, respectively, at 1 years after rectal cancer surgery [7]. The common risk factors for urinary dysfunction included male sex, advanced age, excessive blood loss, postoperative inflammation, operation-related stress, autonomic nerves damage, and so on [8]. And the main cause of urinary dysfunction was that pelvic autonomic nerves were easily inju
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