ABSTRACT
BACKGROUND: To some extent, robotic technique does offer certain benefits in rectal cancer surgery than laparoscopic one, while remains a topic of ongoing debate for rectal cancer patients who had undergone neoadjuvant chemoradiotherapy (NCRT). METHODS: Potential studies published until January 2024 were obtained from Web of Science, Cochrane Library, Embase and PubMed. Dichotomous and continuous variables were expressed as odds ratios (ORs) and weighted mean differences (WMDs) with 95% their confidence intervals (CIs), respectively. A random effects model was used if I2 statistic >50%, otherwise a fixed effects model. RESULTS: Eleven studies involving 1079 patients were analyzed. The robotic-assisted group had an 0.4 cm shorter distance from anal verge (95% CI: -0.680 to -0.114, P=0.006) and 1.94 times higher complete total mesorectal excision (TME) rate (OR=1.936, 95% CI: 1.061 to 3.532, P=0.031). However, the operation time in the robotic-assisted group was 54 minutes longer (95% CI: 20.489 to 87.037, P=0.002) than laparoscopic group. In addition, the robotic-assisted group had a lower open conversion rate (OR=0.324, 95% CI: 0.129 to 0.816, P=0.017) and a shorter length of hospital stay (WMD=-1.127, 95% CI: -2.071 to -0.184, P=0.019). CONCLUSION: Robot-assisted surgery offered several advantages over laparoscopic surgery for locally advanced mid-low rectal cancer following NCRT in terms of resection of lower tumours with improved TME completeness, lower open conversion rate and shorter hospital stay, despite longer operative time.
ABSTRACT
Objective By review of the studies comparing the measurements properties of EuroQol five-dimensional questionnaire (EQ-5D) and short-form 6-dimension health survey (SF-6D) in Chinese populations,this study aims to provide a reference for selecting,applying,and improving the health-related quality of life and health utility measurement tools for Chinese populations.Methods We retrieved the original studies which compared the two tools from both Chinese and English databases and then summarized the findings of the included studies from the measurement properties.Results A total of 12 studies were screened out,including 9 studies about diseased populations and 3 studies about the general populations.The included studies generally demonstrated that both EQ-5D and SF-6D had good feasibility,while the utility scores generated from them cannot be used interchangeably.For the diseased populations,both EQ-5D and SF-6D and their utility scores had good construct validity,including convergent and known-groups validity,while only the utility scores had good construct validity for the general populations.For the diseased populations,SF-6D had smaller ceiling effect and better sensitivity than EQ-5D-3L,while the comparison results between SF-6D and EQ-5D-5L were inconsistent.For the general populations,SF-6D also had better sensitivity than EQ-5D.In addition,there was little comparative evidence for reliability such as test-retest reliability and responsiveness between SF-6D and SF-6D in the two populations.Conclusion This review summarized the characteristics,methods,results,and conclusions of the studies that directly compared the two tools for the populations in China.Although only the studies directly comparing EQ-5D and SF-6D are included in this review,the common findings in these studies provide a basis for better comparison between the two in the future.
