Problem Construction And Evidence Evaluation Of Guidelines For Application Of Robot In Cervical Cancer

Objectives: To build some clinical queries of guideline for robotic surgical system in cervical cancer and to grade the evidence by GRADE.Methods: Defining the purpose of the guideline,determining the type of guideline,selecting the relevant topic and building clinical questions of guideline based on evidence-based principles.The guideline working group conducted a literature review and collected the clinical problems and outcomes of the robotic surgical system applied to cervical cancer in the literature.The first round of summary was summarized.After the merger removes duplicate questions,the clinician was invited to further revise and supplement the questions,and the second round forms the final clinical problems and outcome indicators.The guideline development team conducts searches on the final identified clinical problems.The evidence retrieved is mainly derived from relevant clinical practice guidelines,systematic reviews,or original studies.If relevant high-quality systematic reviews are retrieved we will used directly.If the randomized controls are retrieved,we will permit meta-analysis or describe the effect qualitatively for quantitative synthesis studies.Finally,the results of the study were GRADE graded.Results: Eight clinical problems were constructed in this study,including surgical approaches that should be the first choice for hysterectomy in patients with cervical cancer,robotic assisted laparoscopic surgical resection in the initial treatment of cervical cancer,and Lymph node dissection during cervical cancer of robot-assisted laparoscopic surgery,application of low-pressure pneumoperitoneum in surgery,prevention of postoperative deep venous thrombosis and ureteral injury,and accelerated clinical application of rehabilitation surgical care in postoperative cervical cancer patients.A guideline and two system reviews were directly included as evidence.Five systematic reviews were made and corresponding evidence tables wereproduced.Conclusion: The clinical questions related to the guideline of the robotic surgical system based on evidence-based principles and professional judgement in the treatment of cervical cancer are more in line with clinical practice.However the amount of evidence included is limited and the quality of evidence in most studies is low.It is not conducive to the study of late expert consensus to form recommendations.