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Meta-Analysis
. 2023 Nov;149(16):15207-15217.
doi: 10.1007/s00432-023-05228-6. Epub 2023 Aug 14.

Comparison of robotic‑assisted versus conventional laparoscopic surgery for mid-low rectal cancer: a systematic review and meta-analysis

Qing Yao  1   2   3 , Qian-Nan Sun  3   4 , Jun Ren  5   2   3 , Liu-Hua Wang  5   2   3 , Dao-Rong Wang  6   7   8   9
Affiliations
Meta-Analysis

Comparison of robotic‑assisted versus conventional laparoscopic surgery for mid-low rectal cancer: a systematic review and meta-analysis

Qing Yao et al. J Cancer Res Clin Oncol. 2023 Nov.

Abstract

Purpose: Scarce research has reported the comparison between robotic and laparoscopic surgery in mid-low rectal cancer. Therefore, this meta-analysis is aimed to compare the safety and efficacy of the two surgical approaches.

Methods: A comprehensive search of the databases (PubMed, EMBASE, Cochrane, and Web of Science) was performed for studies comparing robotic and laparoscopic surgery. The outcomes of interest acquired from eight articles included three aspects: intraoperative conditions, postoperative status of patients, and complications. All data (robotic = 1350 patients, laparoscopic = 1330 patients) enrolled were analyzed using Rev Man 5.4.

Results: Compared to the laparoscopic group, the robotic group indicated a noticeable superiority in estimated blood loss (P < 0.0001), number of lymph nodes dissected (P = 0.004), time to first flatus (P = 0.001), time to first fluid diet (P = 0.001), hospital stay (P < 0.0001), conversion (P = 0.009), and urinary retention (P = 0.0006), but devoted much more operation time (P = 0.0004).

Conclusion: Robotic surgery was associated with superiority over laparoscopic surgery in increasing surgical safety, accelerating postoperative recovery, and reducing complications, which suggested that robotic surgery could be a safe and effective method for treating mid-low rectal cancer.

Keywords: Laparoscopic surgery; Mid–low; Rectal cancer; Robotic surgery.

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Conflict of interest statement

The authors have no relevant financial or non-financial interests to disclose.

Figures

Fig. 1
Fig. 1
Flow diagram of articles selection for this meta-analysis
Fig. 2
Fig. 2
Meta-analysis of intraoperative conditions: a estimated blood loss. b Number of lymph nodes dissected. c Operation time
Fig. 3
Fig. 3
Meta-analysis of postoperative status of patients: a time to first flatus. b Time to first fluid diet. c Hospital stay
Fig. 4
Fig. 4
Meta-analysis of complications: a Ureter injury. b Conversion. c Abdominal infection. d Ileus. e Postoperative bleeding. f Urinary retention. g Anastomotic leakage. h Reoperation. i Readmission
Fig. 4
Fig. 4
Meta-analysis of complications: a Ureter injury. b Conversion. c Abdominal infection. d Ileus. e Postoperative bleeding. f Urinary retention. g Anastomotic leakage. h Reoperation. i Readmission
Fig. 5
Fig. 5
Funnel of the number of lymph nodes dissected. SE standard error, MD mean difference
See this image and copyright information in PMC

References

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    1. Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1(8496):1479–1482 - PubMed
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