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Meta-analysis on current status, efficacy, and safety of laparoscopic and robotic ventral mesh rectopexy for rectal prolapse treatment: can robotic surgery become the gold standard?

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International Journal of Colorectal Disease Aims and scope Submit manuscript

Abstract

Purpose

Robotic-assisted surgery and robotic-assisted ventral mesh rectopexy are gaining attention in the treatment of rectal prolapse and increased positive findings are proposed. The objective of this meta-analysis was to investigate whether robotic-assisted ventral mesh rectopexy is comparable with the conventional laparoscopic approach surgery.

Methods

Five major databases (PubMed, Sciencedirect, Web of Science, Embase, and Cochrane Library) were searched for eligible studies. Observational studies of the effect and safety of robotic-assisted and laparoscopic approaches on ventral mesh rectopexy were included. Odd ratios (OR) and weight mean difference (WMD) were used for dichotomous data and continuous data analysis. Clinical outcomes, functional outcomes, and cost-effectiveness data were extracted for meta-analysis.

Results

Compared to the laparoscopic approach, a significant shorter length of hospital stay (LOS), lesser intraoperative blood loss, and lower post-operative complication rate of RVMR group were observed. However, operation time of RVMR was significant increased. The expense of RVMR was higher than LVMR; mean Wexner scores and fecal incontinence were lower in RVMR group while there were no statistical differences.

Conclusion

The result of the current analysis revealed that the robotic-assisted ventral mesh rectopexy is effective and feasible in the treatment of rectal prolapse. However, long-term follow-up and results are needed for the promotion of this approach. There is a long way for robotic-assisted surgery to become a gold standard in rectal surgery.

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Funding

This study is supported by Natural Science Foundation of Tianjin Municipal Science and Technology Commission under grant (grant number: NO.17JCYBJC26100).

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Authors and Affiliations

  1. Department of General Surgery, Tianjin Key Laboratory of Extracorporeal Life Support for Critical Diseases, Institute of Hepatobiliary Disease, Tianjin Third Center Hospital, No.83, Jintang Road, Hedong District, Tianjin, 300170, China

    Xu Bao, Weiliang Song & Yuzhuo Chen

  2. School of nursing, Tianjin Medical University, No.22, Qixiangtai Road, Heping District, Tianjin, 300070, China

    Huan Wang

  3. Institute of Hepatobiliary Disease, Tianjin Third Center Hospital, No.83, Jintang Road, Hedong District, Tianjin, 300170, China

    Ying Luo

Authors
  1. Xu Bao
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  2. Huan Wang
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  4. Yuzhuo Chen
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Contributions

Xu Bao analyzed and interpreted the research data and was the major contributor in the preparation and writing of the manuscript. Huan Wang acquired the original data and conducted the data processing of the meta-analysis. Weiliang Song collected the original data and quality assessment and revised the article critically for important intellectual content. Yuzhuo Chen is responsible for the interpretation of data for the work, visualization, and table and figure production. Ying Luo made substantial contributions to the conception and design of the study and reviewed and edited the manuscript. All authors read and approved the final manuscript.

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Correspondence to Xu Bao.

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Bao, X., Wang, H., Song, W. et al. Meta-analysis on current status, efficacy, and safety of laparoscopic and robotic ventral mesh rectopexy for rectal prolapse treatment: can robotic surgery become the gold standard?. Int J Colorectal Dis 36, 1685–1694 (2021). https://doi.org/10.1007/s00384-021-03885-y

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  • DOI: https://doi.org/10.1007/s00384-021-03885-y

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