AIM: Robot-assisted surgery for rectal cancer may result in lower rates of urogenital dysfunction compared with laparoscopic surgery.
A systematic review was conducted of studies reporting urogenital dysfunction after robot-assisted rectal cancer surgery.
METHODS: Pubmed, Embase, and the Cochrane Library were systematically searched on February 2014. All studies investigating urogenital function after robot-assisted rectal cancer surgery were identified. The inclusion criteria for meta-analysis studies required comparison of robot-assisted with laparoscopic surgery and the evaluation of urological and sexual function by validated questionnaire. The outcome was evaluated using the International Prostate Symptom Score (IPSS), the International Index of Erectile Function (IIEF) and the Female Sexual Function Index (FSFI).
RESULTS: Ten studies including 689 patients were included For the meta-analysis this fell to four including 152 patients in the robotic and 161 in the laparoscopic group, without heterogeneity. The IPSS score at three and twelve months favoured robot-assisted surgery (Mean difference (MD) -1.58 95% CI: [-3.1-0.05] [p = 0.04] and MD -0.90 [-1.81- 0.02] p = 0.05). IIEF scores at three months follow-up (MD -2.59 [-4.25 -0.94] p= 0.002) and six months follow-up (MD -3.06 [-4.53 -1.59] p= 0.0001) were better after robot-assisted than laparoscopic surgery.
CONCLUSION: Although there were few data and no randomized controlled trials the results of the review suggested that robot-assisted surgery resulted in improved urogenital function than after laparoscopy. This article is protected by copyright. All rights reserved.
Written by:
Broholm M, Pommergaard HC, Gögenür I. Are you the author?
Center for Perioperative Optimization, Department of Surgery, Herlev Hospital, University of Copenhagen, Denmark.
Reference: Colorectal Dis. 2014 Dec 16. Epub ahead of print.
doi: 10.1111/codi.12872
PubMed Abstract
PMID: 25515638