Meta-analysis of robotic and laparoscopic surgery for treatment of rectal cancer.
OBJECTIVE
To conduct a meta-analysis to determine the relative merits of robotic surgery (RS) and laparoscopic surgery (LS) for rectal cancer.


METHODS
A literature search was performed to identify comparative studies reporting perioperative outcomes for RS and LS for rectal cancer. Pooled odds ratios and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were calculated using either the fixed effects model or random effects model.


RESULTS
Eight studies matched the selection criteria and reported on 661 subjects, of whom 268 underwent RS and 393 underwent LS for rectal cancer. Compared the perioperative outcomes of RS with LS, reports of RS indicated favorable outcomes considering conversion (WMD: 0.25; 95% CI: 0.11-0.58; P = 0.001). Meanwhile, operative time (WMD: 27.92, 95% CI: -13.43 to 69.27; P = 0.19); blood loss (WMD: -32.35, 95% CI: -86.19 to 21.50; P = 0.24); days to passing flatus (WMD: -0.18, 95% CI: -0.96 to 0.60; P = 0.65); length of stay (WMD: -0.04; 95% CI: -2.28 to 2.20; P = 0.97); complications (WMD: 1.05; 95% CI: 0.71-1.55; P = 0.82) and pathological details, including lymph nodes harvested (WMD: 0.41, 95% CI: -0.67 to 1.50; P = 0.46), distal resection margin (WMD: -0.35, 95% CI: -1.27 to 0.58; P = 0.46), and positive circumferential resection margin (WMD: 0.54, 95% CI: 0.12-2.39; P = 0.42) were similar between RS and LS.


CONCLUSIONS
RS for rectal cancer is superior to LS in terms of conversion. RS may be an alternative treatment for rectal cancer. Further studies are required.
Department of Oncological Surgery, First Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China.
Shuang
S
Lin
Hong-Gang
HG
Jiang
Zhi-Heng
ZH
Chen
Shu-Yang
SY
Zhou
Xiao-Sun
XS
Liu
Ji-Ren
JR
Yu
D002986:Clinical Trials as Topic; D016001:Confidence Intervals; D016208:Databases, Factual; D006801:Humans; D010535:Laparoscopy / Q000295:instrumentation* / Q000379:methods*; D012004:Rectal Neoplasms / Q000601:surgery*; D012371:Robotics / Q000379:methods*; D016896:Treatment Outcome