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Meta-Analysis
. 2018 Mar;32(3):1104-1110.
doi: 10.1007/s00464-017-5980-4. Epub 2017 Dec 7.

Robotic versus laparoscopic right colectomy: an updated systematic review and meta-analysis

Leonardo Solaini  1   2 , Francesca Bazzocchi  3 , Davide Cavaliere  3 , Andrea Avanzolini  3 , Alessandro Cucchetti  4 , Giorgio Ercolani  3   4
Affiliations
Meta-Analysis

Robotic versus laparoscopic right colectomy: an updated systematic review and meta-analysis

Leonardo Solaini et al. Surg Endosc. 2018 Mar.

Abstract

Background: In the right colon surgery, there is a growing literature comparing the safety of robotic right colectomy (RRC) to that of laparoscopic right colectomy (LRC). With this paper we aim to systematically revise and meta-analyze the latest comparative studies on these two minimally invasive procedures.

Methods: A systematic review of studies published from 2000 to 2017 in the PubMed, Scopus, and Embase databases was performed. Primary endpoints were postoperative morbidity and mortality. Secondary endpoints were blood loss, conversion to open surgery, harvested lymph node anastomotic leak, postoperative hemorrhage, abdominal abscess, postoperative ileus, time to first flatus, non-surgical complications, wound infections, hospital stay, and incisional hernia and costs. A subgroup analysis was performed on those series presenting only extracorporeal anastomosis in both arms.

Results: After screening 355 articles, 11 articles with a total of 8257 patients were eligible for inclusion. Operative time was found to be significantly shorter for the laparoscopic procedures in the pooled analysis (SMD - 0.99 95% CI - 1.4 to - 0.6, p < 0.001). Conversion to open surgery was more common during laparoscopic procedures than during the robotic ones (RR 1.7; 95% CI 1.1-2.6, p = 0.02). No significant differences in mortality (RR 0.47; 95% CI 0.18-1.23, p = 0.124) and postoperative complications (RR 1.05; 95% CI 0.9-1.2, p = 0.5) were found between LRC versus RRC. The pooled mean time to first flatus was higher in the laparoscopic group (SMD 0.85 days; 95% CI 0.16-1.54, p = 0.016). Hospital costs were significantly higher in RRCs (SMD - 0.52; 95% CI - 0.52 to - 0.04, p = 0.035).

Conclusions: RRC can be regarded as a feasible and safe technique. Its superiority in terms of postoperative recovery must be confirmed by further large prospective series comparing RRC and LRC performed with the same anastomotic technique. RRC seemed to be associated with higher costs than LRC.

Keywords: Laparoscopy; Meta-analysis; Minimally invasive colectomy; Right hemicolectomy; Robotic.

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References

    1. World J Surg Oncol. 2014 Aug 28;12:274 - PubMed
    1. Surg Endosc. 2013 Jan;27(1):1-10 - PubMed
    1. J Laparoendosc Adv Surg Tech A. 2016 Nov;26(11):882-892 - PubMed
    1. ANZ J Surg. 2003 Sep;73(9):712-6 - PubMed
    1. Dis Colon Rectum. 2003 Dec;46(12):1633-9 - PubMed

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