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Meta-Analysis
. 2016 May 27:6:26981.
doi: 10.1038/srep26981.

Robotic-assisted surgery versus open surgery in the treatment of rectal cancer: the current evidence

Guixiang Liao  1 , Yan-Bing Li  2 , Zhihong Zhao  3 , Xianming Li  1 , Haijun Deng  4 , Gang Li  5
Affiliations
Meta-Analysis

Robotic-assisted surgery versus open surgery in the treatment of rectal cancer: the current evidence

Guixiang Liao et al. Sci Rep. .

Abstract

The aim of this meta-analysis was to comprehensively compare the safety and efficacy of robotic-assisted rectal cancer surgery (RRCS) and open rectal cancer surgery (ORCS). Electronic database (PubMed, EMBASE, Web of Knowledge, and the Cochrane Library) searches were conducted for all relevant studies that compared the short-term and long-term outcomes between RRCS and ORCS. Odds ratios (ORs), mean differences, and hazard ratios were calculated. Seven studies involving 1074 patients with rectal cancer were identified for this meta-analysis. Compared with ORCS, RRCS is associated with a lower estimated blood loss (mean difference [MD]: -139.98, 95% confidence interval [CI]: -159.11 to -120.86; P < 0.00001), shorter hospital stay length (MD: -2.10, 95% CI: -3.47 to -0.73; P = 0.003), lower intraoperative transfusion requirements (OR: 0.52, 95% CI: 0.28 to 0.99, P = 0.05), shorter time to flatus passage (MD: -0.97, 95% CI = -1.06 to -0.88, P < 0.00001), and shorter time to resume a normal diet (MD: -1.71.95% CI = -3.31 to -0.12, P = 0.04). There were no significant differences in surgery-related complications, oncologic clearance, disease-free survival, and overall survival between the two groups. However, RRCS was associated with a longer operative time. RRCS is safe and effective.

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Figures

Figure 1
Figure 1. Flowchart of the literature search.
Figure 2
Figure 2. Meta-analysis of intraoperative data on robotic-assisted rectal cancer surgery versus open rectal cancer surgery.
(A) operative time, (B) estimated blood loss, (C) intraoperative transfusion requirements.
Figure 3
Figure 3. Meta-analysis of postoperative complications associated with robotic-assisted rectal cancer surgery versus open rectal cancer surgery.
(A) overall postoperative complications, (B) postoperative mortality, (C) anastomotic leakage, (D) wound infection, (E) pelvic abscess, (F) ileus, (G) bleeding, (H) urinary retention.
Figure 4
Figure 4. Meta-analysis of outcomes between robotic-assisted rectal cancer surgery and open rectal cancer surgery.
(A) length of stay, (B) pain score, (C) flatus passage, (D) time to diet resumption.
Figure 5
Figure 5. Meta-analysis of the pathological details between robotic-assisted rectal cancer surgery and open rectal cancer surgery.
(A) proximal margin, (B) distal margin, (C) circumferential resection margin, (D) retrieved lymph nodes, (E) positive lymph nodes.
Figure 6
Figure 6. Meta-analysis of disease-free survival in the robotic-assisted rectal cancer surgery group compared with the open rectal cancer surgery group.
Figure 7
Figure 7. Funnel plot of overall postoperative complications associated with robotic-assisted rectal cancer surgery compared with open rectal cancer surgery.
See this image and copyright information in PMC

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