title: Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis.
abstract: BACKGROUND
  Robotic colorectal surgery may solve some of the problems inherent to conventional laparoscopic surgery (CLS). We sought to evaluate the advantages of robot-assisted laparoscopic surgery (RALS) using the da Vinci Surgical System over CLS in patients with benign and malignant colorectal diseases.
  
  
  METHODS
  PubMed and Embase databases were searched for relevant studies published before July 2011. Studies clearly documenting a comparison of RALS with CLS for benign and malignant colorectal diseases were selected. Operative and postoperative measures, resection margins, complications, and related outcomes were evaluated. Weighted mean differences, relative risks, and hazard ratios were calculated using a random-effects model.
  
  
  RESULTS
  The meta-analysis included 16 studies comparing RALS and CLS in patients with colorectal diseases and 7 studies in rectal cancer. RALS was associated with lower estimated blood loss in colorectal diseases (P = 0.04) and rectal cancer (P < 0.001) and lower rates of intraoperative conversion in colorectal diseases (P = 0.03) and rectal cancer (P < 0.001) than CLS. In patients with colorectal diseases, however, operating time (P < 0.001) and total hospitalization cost (P = 0.06) were higher for RALS than for CLS.
  
  
  CONCLUSIONS
  RALS was associated with reduced estimated blood loss and a lower intraoperative conversion rate than CLS, with no differences in complication rates and surrogate markers of successful surgery. Robotic colorectal surgery is a promising tool, especially for patients with rectal cancer.
authors: Department of Surgery, Shanghai Tenth People's Hospital Affiliated to Tongji University, Shanghai, People's Republic of China.
authors: Yongzhi
authors: Y
authors: Yang
authors: Feng
authors: F
authors: Wang
authors: Peng
authors: P
authors: Zhang
authors: Chenzhang
authors: C
authors: Shi
authors: Yang
authors: Y
authors: Zou
authors: Huanlong
authors: H
authors: Qin
authors: Yanlei
authors: Y
authors: Ma
mesh_terms: D015179:Colorectal Neoplasms / Q000601:surgery*; D006801:Humans; D010535:Laparoscopy; D007902:Length of Stay; D011183:Postoperative Complications; D011379:Prognosis; D012371:Robotics