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PL
Purpose: Rectal cancer is one of the most common malignancies of the gastrointestinal tract. The gold standard method is surgical resection. The approach to rectal cancer is still controversial. Nowadays, robotic approach gains popularity in comparison to traditional laparoscopy. However, there is lack of studies assessing rectal resections with primary anastomosis. Methods: We performed a systematic review and meta-analysis according to the PRISMA guidelines. The primary outcomes of interest were morbidity and short-term complications. Results: An initial reference search yielded 1250 articles. Finally, we chose six studies covering 1580 patients that we included in the quantitative analysis. In our study, we demonstrated that laparoscopic and robotic surgery are non-inferior to one another in terms of morbidity (RR=1.1 95% CI: 0.89-1.39), major complication rate (RR=1.01, 95% CI: 0.60-1.69) or in length of hospitalization (MD=0,15 95% CI: -0.60−0.90). The latter has slight advantage in quality of mesorectal excision (RD = -0.19, 95% CI: -0.35 − -0.03. I2=69%) and anastomotic leakage rate (OR=2.25, 95% CI: 1.23-4.09, I2=0%). Conclusion: In certain cases Robotic Surgery provide better quality of resected specimen and lower leakage ratio, nevertheless due to heterogeneity the results are uncertain. There is substantial need for large randomized controlled studies.
EN
Limited independent walking and the resulting disabilities are a serious issue for a growing group of patients. These patients are often dependent on a wheelchair, or are bedridden until the end of their lives. For this reason, the development of gait re-education methods and devices for mechanical gait assistance are very important elements in maintaining or regaining a high quality of daily and social life. New technologies allow for the construction of devices that support the rehabilitation process, which reduce the workload of therapists and ensure the best execution of the patients’ movement patterns. This paper presents the development of devices used for the mechanical support of gait starting from the simplest ones like treadmills or standing frames, through stationary robots, to the most technologically advanced ones, i.e. exoskeletons. An exoskeleton is a wearable robot which supports, or in some cases, substitutes for the user’s own movements. The first attempts to create such devices were undertaken 40 years ago. This paper discusses their clinical applications and their effectiveness in gait re-education based on the existing scientific evidence. These new technologies in gait re-education are now becoming an integral part of the rehabilitation process.
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