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Meta-Analysis
. 2016 Mar 1:14:61.
doi: 10.1186/s12957-016-0816-6.

Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis

Yanlai Sun  1 , Huirong Xu  2 , Zengjun Li  3 , Jianjun Han  4 , Wentao Song  5 , Junwei Wang  6 , Zhongfa Xu  7
Affiliations
Meta-Analysis

Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis

Yanlai Sun et al. World J Surg Oncol. .

Abstract

Background: The objective of this meta-analysis was to compare the clinical and oncologic outcomes of robotic low anterior resection (R-LAR) with conventional laparoscopic low anterior resection (L-LAR).

Methods: A search in the MEDLINE, Embase, and Ovid databases was performed for studies published before July 2014 that compared the clinical and oncologic outcomes of R-LAR and L-LAR. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, a fixed or random effects model was used for the meta-analysis. The clinical and oncologic outcomes evaluated included operative time, estimated blood loss, length of hospital stay, rate of conversion to open surgery, post-operative complications, circumferential margin status, and number of lymph nodes collected.

Results: Eight studies, including 324 R-LAR cases and 268 conventional L-LAR cases, were analyzed. The meta-analysis showed that R-LAR was associated with a shorter hospital stay (mean difference (MD) = -1.03; 95% confidence interval (CI) = -1.78, -0.28; P = 0.007), lower conversion rate (odds ratio (OR) = 0.08; 95% CI = 0.02, 0.31; P = 0.0002), lower rate of circumferential margin involvement (OR = 0.5; 95% CI = 0.25, 1.01; P = 0.05), and lower overall complication rate (MD = 0.65; 95% CI = 0.43, 0.99; P = 0.04) compared with L-LAR. There was no difference in operative time (MD = 28.4; 95% CI = -3.48, 60.27; P = 0.08), the number of lymph nodes removed (MD = -0.63; 95% CI = -0.78, 2.05; P = 0.38), and days to return of bowel function (MD = -0.15; 95% CI = -0.37, 0.06; P = 0.17).

Conclusions: R-LAR was shown to be associated with a shorter hospital stay, lower conversion rate, lower rate of circumferential margin involvement, and lower overall complication rate compared with L-LAR. There were no differences in operative time, the number of lymph nodes removed, and days to return of bowel function.

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Figures

Fig. 1
Fig. 1
Flow diagram of study selection for meta-analysis
Fig. 2
Fig. 2
Robotic compared with laparoscopic low anterior resection for cancer: operative time
Fig. 3
Fig. 3
Robotic compared with laparoscopic low anterior resection for cancer: length of hospital stay
Fig. 4
Fig. 4
Robotic compared with laparoscopic low anterior resection for cancer: length of hospital stay
Fig. 5
Fig. 5
Robotic compared with laparoscopic low anterior resection for cancer: number of harvested lymph nodes
Fig. 6
Fig. 6
Robotic compared with laparoscopic low anterior resection for cancer: positive circumferential resection margin involvement
Fig. 7
Fig. 7
Robotic compared with laparoscopic low anterior resection for cancer: post-operative overall complications
Fig. 8
Fig. 8
Robotic compared with laparoscopic low anterior resection for cancer: days to return of bowel function
See this image and copyright information in PMC

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