title: Robotic assistance may reduce conversion to open in rectal carcinoma laparoscopic surgery: systematic review and meta-analysis.
abstract: BACKGROUND
  We hypothesized that robotic assistance (RARS) could provide better intraoperative and short-term outcomes than a traditional laparoscopic approach (LARS) to rectal cancer surgery.
  
  
  METHODS
  Systematic review of the literature, including electronic searches and communications to international robotic meetings.
  
  
  METHODS
  studies involving rectal cancer patients and comparing outcomes of robotic surgery vs laparoscopic surgery. Primary end-points: conversion and postoperative short-term complications. Meta-analysis performed using Review Manager 5.0 software.
  
  
  RESULTS
  Five case-control studies involving 486 patients (203 RARS-283 LARS) were finally included. Conversion to open rate (RR = 0.31; 95% CI 0.12,0.78) was lower for RARS. No differences were found in oncological outcomes, hospital stay or anastomotic leakage.
  
  
  CONCLUSIONS
  This meta-analysis of available non-randomized studies suggests that conversion to open rate may be reduced when using RARS instead of LARS for rectal cancer.
authors.affiliation: General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain. elenaortiz@seclaendosurgery.com
authors.forename: Elena
authors.initials: E
authors.lastname: Ortiz-Oshiro
authors.forename: Iris
authors.initials: I
authors.lastname: Sánchez-Egido
authors.forename: Jesús
authors.initials: J
authors.lastname: Moreno-Sierra
authors.forename: Cristina Fernández
authors.initials: CF
authors.lastname: Pérez
authors.forename: Jesús Sánchez
authors.initials: JS
authors.lastname: Díaz
authors.forename: Jesús Álvarez
authors.initials: JÁ
authors.lastname: Fernández-Represa
mesh_terms: D016063:Blood Loss, Surgical; D003365:Costs and Cost Analysis; D013505:Digestive System Surgical Procedures / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000191:economics / Q000379:methods; D007902:Length of Stay; D008297:Male; D061646:Operative Time; D011183:Postoperative Complications; D012004:Rectal Neoplasms / Q000473:pathology / Q000601:surgery*; D012371:Robotics / Q000191:economics / Q000379:methods*; D025321:Surgery, Computer-Assisted / Q000009:adverse effects / Q000191:economics / Q000379:methods*; D016896:Treatment Outcome