Robotic Rectal Resection for Rectal Cancer in Elderly Patients: A Systematic Review and Meta-Analysis
Abstract
:1. Introduction
2. Materials and Methods
2.1. Literature Search and Selection
2.2. Statistical Analysis
2.3. Heterogeneity
2.4. Quality Assessment
3. Results
3.1. Literature Selection
3.2. Study and Patient Characteristics
3.3. Risk of Bias
3.4. Oncologic Surgical Quality
3.5. Postoperative Outcomes
3.6. Survival Outcomes
4. Discussion
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
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Study | Country | Study Design | Patients | Mean Age (SD) | Sex (M/F) | ASA (I/II/III/IV) | Neoadjuvant Therapy Yes/No | cT Stage (T1/T2/T3/T4) | cN Stage (N0/N1/N2) | cM Stage (M0/M1) |
---|---|---|---|---|---|---|---|---|---|---|
Oldani [19] 2017 | Italy | Retrospective study | 7 young | 57.12 (5.5) | 4M/3F | 1/6/0/0 | 4/3 | ND | ND | 6/1 |
8 elderly | 81.9 (6.28) | 4M/4F | 0/2/6/0 | 2/6 | ND | ND | 7/1 | |||
Ramallo-Solis [20] 2019 | Spain | Retrospective analysis of a prospective database | 108 young | 60 (7.69) | 65M/43F | 12/69/27/0 | 71/37 | 4/25/78/1 | 41/41/26 | 102/6 |
43 elderly | 74.74 (3.566) | 29M/14F | 0/15/28/0 | 24/19 | 1/11/30/1 | 14/20/9 | 43/0 | |||
Su [21] 2021 | Taiwan | Retrospective study | 126 young | 56.7 (7.9) | 77M/49F | 0/96/30/0 | 90/80 | 4/26/81/15 | 55/45/26 | ND |
30 elderly | 77.7 (5.63) | 17M/13F | 0/7/22/1 | 22/8 | ¼/23/2 | 13/16/1 | ND | |||
Tot. | 241 young | 58,19 (7.11) | 144M/95F | 13/171/57/0 | 143/111 | |||||
81 elderly | 76,54 (5.29) | 50M/31F | 0/24/56/1 | 69/43 |
Study | Representativeness of Exposed Cohort | Selection of Non-Exposed Cohort | Ascertainment of Exposure | Absence of Outcome of Interest at Start of Study | Comparability of Cohorts on the Basis of Design or Analysis | Assessment of Outcome | Follow-Up Enough for Outcome to Occur | Adequacy of Follow-Up of Cohorts | Score | Quality |
---|---|---|---|---|---|---|---|---|---|---|
Oldani [19] | * | * | * | * | ** | * | * | - | 8 | Good |
Ramallo-Solis [20] | * | * | * | * | ** | * | * | - | 8 | Good |
Su [21] | * | * | * | * | ** | * | * | - | 8 | Good |
Outcome | N of Studies | Means (SD) | Heterogeneity of Trials | p-Value for Differences across Studies | Mean Difference (C.I. 95%) | ||
---|---|---|---|---|---|---|---|
p-Value | I2 Statistic | ||||||
Distal margin | 3 | Young 2.93 (0.46) | Elderly 2.37 (0.78) | 0.07 | 62% | 0.52 | −0.47 (−1.92, 0.97) |
N. of harvested lymph nodes | 3 | Young 14.02 (1.83) | Elderly 12.70 (2.31) | 0.96 | 0% | 0.16 | −1.51 (−3.62, 0.59) |
Outcome | No. of Studies | No. of Events or Mean (SD) | Heterogeneity of Trials | p-Value for Differences across Studies | OR, Mean or Risk Difference (C.I. 95%) | ||
---|---|---|---|---|---|---|---|
p-Value | I2 Statistic | ||||||
Conversion rate | 3 | Young 14/241 | Elderly 7/81 | 0.73 | 0% | 0.63 | 0.02 (−0.05, 0.09) |
Length of stay (LOS) | 3 | Young 13.19 (1.56) | Elderly 16.29 (4.08) | 0.28 | 22% | 0.56 | 1.23 (−2.91, 5.38) |
Overall complications | 3 | Young 56/241 | Elderly 17/81 | 0.68 | 0% | 0.71 | 0.89 (0.48, 1.65) |
Postoperative mortality | 3 | Young 0/241 | Elderly 0/81 | 1.00 | 0% | 1.00 | 0.00 (−0.03, 0.03) |
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Reddavid, R.; Sofia, S.; Puca, L.; Moro, J.; Ceraolo, S.; Jimenez-Rodriguez, R.; Degiuli, M. Robotic Rectal Resection for Rectal Cancer in Elderly Patients: A Systematic Review and Meta-Analysis. J. Clin. Med. 2023, 12, 5331. https://doi.org/10.3390/jcm12165331
Reddavid R, Sofia S, Puca L, Moro J, Ceraolo S, Jimenez-Rodriguez R, Degiuli M. Robotic Rectal Resection for Rectal Cancer in Elderly Patients: A Systematic Review and Meta-Analysis. Journal of Clinical Medicine. 2023; 12(16):5331. https://doi.org/10.3390/jcm12165331
Chicago/Turabian StyleReddavid, Rossella, Silvia Sofia, Lucia Puca, Jacopo Moro, Simona Ceraolo, Rosa Jimenez-Rodriguez, and Maurizio Degiuli. 2023. "Robotic Rectal Resection for Rectal Cancer in Elderly Patients: A Systematic Review and Meta-Analysis" Journal of Clinical Medicine 12, no. 16: 5331. https://doi.org/10.3390/jcm12165331