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Meta-Analysis
. 2021 Dec;17(6):e2329.
doi: 10.1002/rcs.2329. Epub 2021 Sep 9.

Robotic rectal resection preserves anorectal function: Systematic review and meta-analysis

Julia K Grass  1 , Chien-Chih Chen  2   3 , Nathaniel Melling  1 , Bharathi Lingala  4 , Marius Kemper  1 , Pasquale Scognamiglio  1 , Roberto Persiani  5 , Flavio Tirelli  5 , Marco Caricato  6 , Gabriella T Capolupo  6 , Jakob R Izbicki  1 , Daniel R Perez  1
Affiliations
Meta-Analysis

Robotic rectal resection preserves anorectal function: Systematic review and meta-analysis

Julia K Grass et al. Int J Med Robot. 2021 Dec.

Abstract

Background: Improving survival rates in rectal cancer patients has generated a growing interest in functional outcomes after total mesorectal excision (TME). The well-established low anterior resection syndrome (LARS) score assesses postoperative anorectal impairment after TME. Our meta-analysis is the first to compare bowel function after open, laparoscopic, transanal, and robotic TME.

Methods: All studies reporting functional outcomes after rectal cancer surgery (LARS score) were included, and were compared with a consecutive series of robotic TME (n = 48).

Results: Thirty-two publications were identified, including 5 565 patients. Anorectal function recovered significantly better within one year after robotic TME (3.8 [95%CI -9.709-17.309]) versus laparoscopic TME (26.4 [95%CI 19.524-33.286]), p = 0.006), open TME (26.0 [95%CI 24.338-29.702], p = 0.002) and transanal TME (27.9 [95%CI 22.127-33.669], p = 0.003).

Conclusions: Robotic TME enables better recovery of anorectal function compared to other techniques. Further prospective, high-quality studies are needed to confirm the benefits of robotic surgery.

Keywords: LARS, minimally-invasive surgery; anorectal function; laparoscopy; rectal cancer; rectal resection; robotic surgery, total mesorectal excision.

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References

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