基于CiteSpace的机器人结直肠手术临床应用现状与热点可视化分析

Visualization analysis of current status and hotspots of clinical application of robot-assisted colorectal surgery based on CiteSpace

背景与目的:结直肠癌是一种临床上常见的恶性肿瘤,其手术治疗是近年来外科领域的研究热点之一。近年来,越来越多的学者开始关注机器人手术在结直肠外科领域的应用和研究。本研究通过利用CiteSpace软件对近年来机器人结直肠手术研究文献进行可视化分析,探讨世界范围内机器人手术在结直肠手术的发展历程与诊治方法的演进过程,分析其研究热点和发展趋势,了解当前热点并确定潜在的新研究方向,为后续的研究提供新的线索和思路。方法:检索1999年1月1日—2023年9月30日之间Web of Sciences核心合集(WoSCC)数据库与在中国知网(CNKI)数据库中机器人结直肠手术的相关中英文文献,采用CiteSpace 5.8.R3软件分析该领域文献的发文国家(地区)、高产机构、作者及合作关系等,对关键词进行聚类、突现、时线图和时区图分析,绘制可视化的知识图谱。结果:共纳入3 135篇文献,其中WoSCC数据库2 760篇、CNKI数据库375篇。分析结果显示,该领域发文量逐年增多,尤其在2011年之后上升幅度增大,2021年达到最高峰。目前,发文量居前列的分别是美国(758篇)、意大利(253篇)、中国(173篇)。国外发文量前三的机构分别为韩国延世大学(76篇)、韩国大学(53篇)和美国梅奥诊所(41篇);中文发文量前列的机构分别为复旦大学附属中山医院(11篇)、华中科技大学同济医学院附属协和医院(6篇)、南昌大学第一附属医院(6篇)和沈阳军区总医院(6篇)。国外发文量前三的作者均来自韩国,大部分作者形成广泛合作网络;中文发文前三的作者分别来自复旦大学附属中山医院、甘肃省人民医院和江苏省中医院,大部分作者仅为独立研究团队,仅少数存在合作关系。关键词分析结果显示,国外发展趋势以结直肠相关肝脏切除、术后生存率、手术危险因素和患者术后生存质量为主,而国内的趋势是手术的新应用、达芬奇机器人的操作系统以及专家共识和专著的编写;国外热点和趋势集中在临床随机对照试验和开放标签;国内热点集中在手术技术、机器人操作系统以及与其他技术结合的方面。结论:机器人结直肠手术是微创外科学研究的热点之一。与国际水平相比,国内机器人手术研究及临床应用相对滞后,主要表现在起步时间晚、高质量论文数量少、被引频次少、与其他国家或机构合作度低等方面。开展随机对照试验、如何减少围手术期风险、提高术后患者生存率和生存质量是机器人结直肠手术的研究热点和前沿。

Background and Aims:Colorectal cancer is a common malignant tumor in clinical practice,and its surgical treatment has become one of the research hotspots in the field of surgery in recent years.Robotassisted surgery,representing the most advanced surgical technology,has rapidly developed in the field of colorectal surgery,and an increasing number of scholars have begun to focus on its application and research in this field.Using Cite Space software,this study conducted a visual analysis of recent literature on robot-assisted colorectal surgery to explore the development process and evolution of diagnosis and treatment methods of robotic surgery in colorectal surgery worldwide,analyze the research hotspots and trends,identify current hot topics,and determine potential new research directions,so as to provide new clues and ideas for subsequent research.Methods:Relevant Chinese and English literature on robot-assisted colorectal surgery in the Web of Science Core Collection(Wo SCC) database and the China National Knowledge Infrastructure(CNKI) database between January 1,1999 and September 30,2023 were retrieved.Cite Space 5.8.R3 software was used to analyze the publication countries(regions),prolific institutions,authors,and collaboration relationships in this field.Clustering,burst detection,timeline,and time zone analyses were performed on keywords to draw visual knowledge maps.Results:A total of 3 135 articles were included,with 2 760 from the Wo SCC database and 375 from the CNKI database.The analysis showed that the number of publications in this field has been increasing year by year,especially after 2011,with a significant increase,reaching its peak in 2021.Currently,the leading countries in publications were the United States(758 articles),Italy(253 articles),and China(173 articles).The top three foreign institutions in terms of publications were Yonsei University in Republic of Korea(76 articles),Korean University(53 articles),and Mayo Clinic in the United States(41 articles).The leading Chinese institutions in terms of publications were Zhongshan Hospital Affiliated to Fudan University(11 articles),Tongji Medical College Affiliated Union Hospital of Huazhong University of Science and Technology(6 articles),the First Affiliated Hospital of Nanchang University(6 articles),and the General Hospital of Shenyang Military Region(6 articles).The top three foreign authors came from Republic of Korea,with most authors forming a wide cooperation network.The top three Chinese authors were from Zhongshan Hospital Affiliated to Fudan University,Gansu Provincial People's Hospital,and Jiangsu Province Hospital of Traditional Chinese Medicine,with most authors belonging to independent research teams and only a few having collaborative relationships.Keyword analysis results show that the foreign development trends mainly focused on colorectal cancerrelated liver resection,postoperative survival rate,surgical risk factors,and postoperative survival quality,while domestic trends included new applications of surgery,the operation system of the da Vinci robot,and the compilation of expert consensus and monographs;foreign hotspots and trends were concentrated on clinical randomized controlled trials and open labels,while domestic hotspots focused on surgical techniques,robot operation systems,and integration with other technologies.Conclusion:Robot-assisted colorectal surgery is one of the hot topics in the research of minimally invasive surgery.Compared with the international level,research and clinical application of robot surgery in China are relatively lagging,mainly manifested in late start time,few high-quality papers,low citation frequency,and low degree of cooperation with other countries or institutions.Conducting randomized controlled trials,reducing perioperative risks,and improving postoperative patient survival rates and quality of life are the research hotspots and frontiers of robot-assisted colorectal surgery.