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Meta-Analysis
. 2014 Aug 28:12:274.
doi: 10.1186/1477-7819-12-274.

Robotic versus laparoscopic right colectomy: a meta-analysis

Huirong Xu, Jianning Li, Yanlai Sun  1 , Zengjun Li, Yanan Zhen, Bin Wang, Zhongfa Xu
Affiliations
Meta-Analysis

Robotic versus laparoscopic right colectomy: a meta-analysis

Huirong Xu et al. World J Surg Oncol. .

Abstract

Background: The objective of this meta-analysis was to compare the clinical safety and efficacy of robotic right colectomy (RRC) with conventional laparoscopic right colectomy (LRC).

Methods: A literature search was performed for comparative studies reporting perioperative outcomes of RRC and LRC. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, the fixed effects model or the random effects model were used for the meta-analysis. Operative time, estimated blood loss, length of hospital stay, conversion rates to open surgery, postoperative complications, and related outcomes were evaluated.

Results: Seven studies, including 234 RRC cases and 415 conventional LRC cases, were analyzed. The meta-analysis showed that RRC had longer operative times (P < 0.00001), lower estimated blood losses (P = 0.0002), lower postoperative overall complications (P = 0.02), and significantly faster bowel function recovery (P < 0.00001). There were no differences in the length of hospital stay (P = 0.12), conversion rates to open surgery (P = 0.48), postoperative ileus (P = 0.08), anastomosis leakage (P = 0.28), and bleeding (P = 0.95).

Conclusions: Compared to LRC, RRC was associated with reduced estimated blood losses, reduced postoperative complications, longer operative times, and a significantly faster recovery of bowel function. Other perioperative outcomes were equivalent.

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Figures

Figure 1
Figure 1
Flow diagram of study selection for the meta-analysis.
Figure 2
Figure 2
Analysis of the operating time. Forest plot of comparison between robotic right colectomy and conventional laparoscopic right colectomy. instrumental variables (IV) is used to estimate causal relationships when controlled experiments are not feasible.
Figure 3
Figure 3
Analysis of the length of hospital stay. Forest plot of comparison between robotic right colectomy and conventional laparoscopic right colectomy. instrumental variables (IV) is used to estimate causal relationships when controlled experiments are not feasible.
Figure 4
Figure 4
Analysis of the estimated blood loss. Forest plot of comparison between robotic right colectomy and conventional laparoscopic right colectomy instrumental variables (IV) is used to estimate causal relationships when controlled experiments are not feasible.
Figure 5
Figure 5
Analysis of overall postoperative complications. Forest plot of comparison between robotic right colectomy and conventional laparoscopic right colectomy. Meta-analyses of dichotomous variables were performed using the Mantel–Haenszel (M-H) method.
See this image and copyright information in PMC

References

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