医学
生活质量(医疗保健)
荟萃分析
腹腔镜手术
梅德林
社会心理的
随机对照试验
置信区间
物理疗法
机械人手术
模式
外科
腹腔镜检查
普通外科
内科学
护理部
社会学
法学
精神科
社会科学
政治学
作者
Russell Seth Martins,Asad Saulat Fatimi,Omar Mahmud,Arshia Jahangir,Muhammad Umar Mahar,Syed Roohan Aamir,Maria Khan,Ali Ahmad
标识
DOI:10.1007/s00268-023-06936-3
摘要
Abstract Introduction Maximizing patients’ quality of life (QoL) is a central goal in surgical oncology. Currently, both laparoscopic and robotic surgery are viable options in rectal cancer (RC) resections. The aim of this systematic review was to analyze the differences in postoperative QoL between the two operative modalities. Methodology This review was conducted in adherence to the PRISMA guidelines. MEDLINE, Embase, Scopus, and CENTRAL databases were searched for articles comparing QoL in patients undergoing laparoscopic versus robotic surgery for RC. Seven studies were included (two randomized controlled trials, four prospective cohorts, and one retrospective cohort) out of which six reported data suitable for meta‐analysis. Global QoL and QoL subdomains, such as physical and social functioning, were meta‐analyzed using a random‐effects model. Risk of bias was assessed using the ROBINS‐I and Cochrane RoB‐2 tools. Results Data on 869 patients (440 laparoscopic and 429 robotic surgery) across six studies were meta‐analyzed. There was no significant difference in global QoL (Mean Difference:−0.43 [95% Confidence Interval:−3.49–2.62]). Physical functioning was superior after robotic surgery (1.92 [0.97–2.87]). However, nausea/vomiting, pain, and fatigue did not differ between groups. Perception of body image was worse after laparoscopic surgery (−5.06 [−9.05– −1.07]). Other psychosocial subdomains (emotional, cognitive, role, and social functioning) were comparable between groups. Conclusion Laparoscopic and robotic surgery for RC have comparable QoL overall, for both physical and psychological dimensions. Our results may assist the management‐related decision‐making in surgical treatment of RC.
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