Should we encourage the use of robotic technologies in complicated diverticulitis? Results of systematic review and meta-analysis.
| العنوان: | Should we encourage the use of robotic technologies in complicated diverticulitis? Results of systematic review and meta-analysis. |
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| المؤلفون: | Panin SI; Department of General Surgery, Volgograd State Medical University, Volgograd, Russia., Nechay TV; Research Institute of Clinical Surgery, Pirogov Russian National Research Medical University, Moscow, Russia., Sazhin AV; Research Institute of Clinical Surgery, Pirogov Russian National Research Medical University, Moscow, Russia., Tyagunov AE; Research Institute of Clinical Surgery, Pirogov Russian National Research Medical University, Moscow, Russia., Shcherbakov NA; Research Institute of Clinical Surgery, Pirogov Russian National Research Medical University, Moscow, Russia., Bykov AV; Department of General Surgery, Volgograd State Medical University, Volgograd, Russia., Melnikov-Makarchuk KY; Research Institute of Clinical Surgery, Pirogov Russian National Research Medical University, Moscow, Russia., Yuldashev AG; Research Institute of Clinical Surgery, Pirogov Russian National Research Medical University, Moscow, Russia., Kuznetsov AA; Department of General Surgery, Volgograd State Medical University, Volgograd, Russia. |
| المصدر: | Frontiers in robotics and AI [Front Robot AI] 2023 Sep 13; Vol. 10, pp. 1208611. Date of Electronic Publication: 2023 Sep 13 (Print Publication: 2023). |
| نوع المنشور: | Systematic Review |
| اللغة: | English |
| بيانات الدورية: | Publisher: Frontiers Media SA Country of Publication: Switzerland NLM ID: 101749350 Publication Model: eCollection Cited Medium: Internet ISSN: 2296-9144 (Electronic) Linking ISSN: 22969144 NLM ISO Abbreviation: Front Robot AI Subsets: PubMed not MEDLINE |
| أسماء مطبوعة: | Original Publication: Lausanne, Switzerland : Frontiers Media SA, [2014]- |
| مستخلص: | Introduction: Complicated diverticulitis is a common abdominal emergency that often requires a surgical intervention. The systematic review and meta-analysis below compare the benefits and harms of robotic vs. laparoscopic surgery in patients with complicated colonic diverticular disease. Methods: The following databases were searched before 1 March 2023: Cochrane Library, PubMed, Embase, CINAHL, and ClinicalTrials.gov. The internal validity of the selected non-randomized studies was assessed using the ROBINS-I tool. The meta-analysis and trial sequential analysis were performed using RevMan 5.4 (Cochrane Collaboration, London, United Kingdom) and Copenhagen Trial Unit Trial Sequential Analysis (TSA) software (Copenhagen Trial Unit, Center for Clinical Intervention Research, Rigshospitalet, Copenhagen, Denmark), respectively. Results: We found no relevant randomized controlled trials in the searched databases. Therefore, we analyzed 5 non-randomized studies with satisfactory internal validity and similar designs comprising a total of 442 patients (184 (41.6%) robotic and 258 (58.4%) laparoscopic interventions). The analysis revealed that robotic surgery for complicated diverticulitis (CD) took longer than laparoscopy (MD = 42 min; 95% CI: [-16, 101]). No statistically significant differences were detected between the groups regarding intraoperative blood loss (MD = -9 mL; 95% CI: [-26, 8]) and the rate of conversion to open surgery (2.17% or 4/184 for robotic surgery vs. 6.59% or 17/258 for laparoscopy; RR = 0.63; 95% CI: [0.10, 4.00]). The type of surgery did not affect the length of in-hospital stay (MD = 0.18; 95% CI: [-0.60, 0.97]) or the rate of postoperative complications (14.1% or 26/184 for robotic surgery vs. 19.8% or 51/258 for laparoscopy; RR = 0.81; 95% CI: [0.52, 1.26]). No deaths were reported in either group. Discussion: The meta-analysis suggests that robotic surgery is an appropriate option for managing complicated diverticulitis. It is associated with a trend toward a lower rate of conversion to open surgery and fewer postoperative complications; however, this trend does not reach the level of statistical significance. Since no high quality RCTs were available, this meta-analysis isnot able to provide reliable conclusion, but only a remarkable lack of proper evidence supporting robotic technology. The need for further evidence-based trials is important. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2023 Panin, Nechay, Sazhin, Tyagunov, Shcherbakov, Bykov, Melnikov-Makarchuk, Yuldashev and Kuznetsov.) |
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| فهرسة مساهمة: | Keywords: complicated diverticulitis; diverticular disease; robotic surgery; robotic technologies in complicated diverticulitis; robotic urgent surgery |
| تواريخ الأحداث: | Date Created: 20231002 Latest Revision: 20231003 |
| رمز التحديث: | 20231003 |
| مُعرف محوري في PubMed: | PMC10533995 |
| DOI: | 10.3389/frobt.2023.1208611 |
| PMID: | 37779579 |
| قاعدة البيانات: | MEDLINE |
| تدمد: | 2296-9144 |
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| DOI: | 10.3389/frobt.2023.1208611 |