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. 2023 Oct 26:13:1273378.
doi: 10.3389/fonc.2023.1273378. eCollection 2023.

Comparison of robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection: a systemic review and meta-analysis of randomized controlled trials

Zhilong Huang #  1 , Shibo Huang #  1 , Yanping Huang  1 , Raoshan Luo  1 , Weiming Liang  1
Affiliations

Comparison of robotic-assisted versus conventional laparoscopic surgery in colorectal cancer resection: a systemic review and meta-analysis of randomized controlled trials

Zhilong Huang et al. Front Oncol. .

Abstract

Introduction: There is still controversy on whether or not robot-assisted colorectal surgery (RACS) have advantages over laparoscopic-assisted colorectal surgery(LACS).

Materials and methods: The four databases (PubMed, Embase, Web of Science and Cochrane Library)were comprehensively searched for randomized controlled trials (RCTs) comparing the outcomes of RACS and LACS in the treatment of colorectal cancer from inception to 22 July 2023.

Results: Eleven RCTs were considered eligible for the meta-analysis. Compared with LACS,RACS has significantly longer operation time(MD=5.19,95%CI: 18.00,39.82, P<0.00001), but shorter hospital stay(MD=2.97,95%CI:-1.60,-0.33,P = 0.003),lower conversion rate(RR=3.62,95%CI:0.40,0.76,P = 0.0003), lower complication rate(RR=3.31,95%CI:0.64,0.89,P=0.0009),fewer blood loss(MD=2.71,95%CI:-33.24,-5.35,P = 0.007),lower reoperation rate(RR=2.12, 95%CI:0.33,0.96,P=0.03)and longer distal resection margin(MD=2.16, 95%CI:0.04,0.94, P = 0.03). There was no significantly difference in harvested lymph nodes, the time of first flatus, the time of first defecation,the time of first resume diet, proximal resection margin, readmission rates, mortalities and CRM+ rates between two group.

Conclusions: Our study indicated that RACS is a feasible and safe technique that can achieve better surgical efficacy compared with LACS in terms of short-term outcomes.

Systematic review registration: https://www.crd.york.ac.uk/prospero/, identifier CRD42023447088.

Keywords: colorectal cancer; complication; laparoscopic-assisted colorectal surgery; randomized controlled trial; robot-assisted colorectal surgery.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Flow chart of literature search strategies.
Figure 2
Figure 2
Risk of bias assessment for the included studies.
Figure 3
Figure 3
Forest plot of the meta-analysis for clinical outcomes. (A) Operative time. (B) Length of stay. (C) Blood loss. (D) The number of harvested lymph nodes.
Figure 4
Figure 4
Forest plot of the meta-analysis for clinical outcomes. (A) Conversion. (B) Complications. (C) CRM+.
Figure 5
Figure 5
Forest plot of the meta-analysis for clinical outcomes. (A) Proximal resection margin. (B) Distal resection margin.
Figure 6
Figure 6
Forest plot of the meta-analysis for clinical outcomes. (A) Time of first flatus. (B) Time of first autonomous urination. (C) Time of first defecation. (D) Time of first resume diet.
Figure 7
Figure 7
Forest plot of the meta-analysis for clinical outcomes. (A) Reoperation rates. (B) Readmission rates. (C) Death rates.
Figure 8
Figure 8
Forest plot of the meta-analysis for complete rates of TME.
Figure 9
Figure 9
Funnel plot. (A) Conversion rates. (B) complication rates.
See this image and copyright information in PMC

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