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Urological and sexual function after robotic and laparoscopic surgery for rectal cancer: A systematic review, meta‐analysis and meta‐regression
Author(s) -
Wee Ian Jun Yan,
Kuo LiJen,
Ngu James ChiYong
Publication year - 2021
Publication title -
the international journal of medical robotics and computer assisted surgery
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.556
H-Index - 53
eISSN - 1478-596X
pISSN - 1478-5951
DOI - 10.1002/rcs.2164
Subject(s) - medicine , meta analysis , confidence interval , sexual function , genitourinary system , prostate cancer , international prostate symptom score , grading (engineering) , laparoscopic surgery , urinary retention , surgery , prostate , laparoscopy , cancer , lower urinary tract symptoms , civil engineering , engineering
Background This systematic review sought to compare the urogenital functions after laparoscopic (LAP) and robotic (ROB) surgery for rectal cancer. Methods This study conformed to the Preferred Reporting Items for Systematic Reviews and Meta‐Analyses guidelines. Results Twenty‐six studies ( n = 2709 for ROB, n = 2720 for LAP) were included. There was a lower risk of 30‐day urinary retention in the ROB group (risk ratios 0.78, 95% confidence interval [CI] 0.61–0.99), but the long‐term risk was comparable ( p = 0.460). Meta‐regression showed a small, positive relationship between age and risk of 30‐day urinary retention in both the ROB ( p = 0.034) and LAP groups ( p = 0.004). The International Prostate Symptom Score was better in the ROB group at 3 months (mean difference [MD] −1.58, 95% CI −3.10 to −0.05). The International Index of Erectile Function score was better in the ROB group at 6 months (MD 4.06, 95% CI 2.38 – 5.74). Conclusion While robotics may improve urogenital function after rectal surgery, the quality of evidence is low based on the Grading of Recommendations, Assessment, Development and Evaluation approach.