title: Robotic versus Laparoscopic Approach in Colonic Resections for Cancer and Benign Diseases: Systematic Review and Meta-Analysis.
abstract: OBJECTIVE
  The aim of this systematic review and meta-analysis is to compare robotic colectomy (RC) with laparoscopic colectomy (LC) in terms of intraoperative and postoperative outcomes.
  
  
  METHODS
  A systematic literature search was performed to retrieve comparative studies of robotic and laparoscopic colectomy. The databases searched were PubMed, Embase and the Cochrane Central Register of Controlled Trials from January 2000 to October 2014. The Odds ratio, Risk difference and Mean difference were used as the summary statistics.
  
  
  RESULTS
  A total of 12 studies, which included a total of 4,148 patients who had undergone robotic or laparoscopic colectomy, were included and analyzed. RC demonstrated a longer operative time (MD 41.52, P<0.00001) and higher cost (MD 2.42, P<0.00001) than did LC. The time to first flatus passage (MD -0.51, P = 0.003) and the length of hospital stay (MD -0.68, P = 0.01) were significantly shorter after RC. Additionally, the intraoperative blood loss (MD -16.82, P<0.00001) was significantly less in RC. There was also a significantly lower incidence of overall postoperative complications (OR 0.74, P = 0.02) and wound infections (RD -0.02, P = 0.03) after RC. No differences in the postoperative ileus, in the anastomotic leak, or in the conversion to open surgery rate and in the number of harvested lymph nodes outcomes were found between the approaches.
  
  
  CONCLUSIONS
  The present meta-analysis, mainly based on observational studies, suggests that RC is more time-consuming and expensive than laparoscopy but that it results in faster recovery of bowel function, a shorter hospital stay, less blood loss and lower rates of both overall postoperative complications and wound infections.
authors.affiliation: Department of Gastrointestinal Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Stefano
authors.initials: S
authors.lastname: Trastulli
authors.affiliation: Department of Gastrointestinal Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Roberto
authors.initials: R
authors.lastname: Cirocchi
authors.affiliation: Department of Gastrointestinal Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Jacopo
authors.initials: J
authors.lastname: Desiderio
authors.affiliation: Department of Oncology, Division of Oncological and Robotic Surgery, Careggi University Hospital, Florence, Italy.
authors.forename: Andrea
authors.initials: A
authors.lastname: Coratti
authors.affiliation: Department of Surgical Science, "Sapienza" University, Rome, Italy.
authors.forename: Salvatore
authors.initials: S
authors.lastname: Guarino
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Claudio
authors.initials: C
authors.lastname: Renzi
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Alessia
authors.initials: A
authors.lastname: Corsi
authors.affiliation: Department of General and Oncologic Surgery, University of Perugia, Perugia, Italy.
authors.forename: Carlo
authors.initials: C
authors.lastname: Boselli
authors.affiliation: Department of Surgical Science, "Sapienza" University, Rome, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Santoro
authors.affiliation: Department of Experimental Medicine, Public Health Section, University of Perugia. Perugia, Italy.
authors.forename: Liliana
authors.initials: L
authors.lastname: Minelli
authors.affiliation: Department of Gastrointestinal Surgery and Liver Unit, St. Maria Hospital, Terni, Italy.
authors.forename: Amilcare
authors.initials: A
authors.lastname: Parisi
mesh_terms: D003110:Colonic Neoplasms / Q000473:pathology / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D010535:Laparoscopy / Q000009:adverse effects / Q000379:methods*; D008297:Male; D064887:Observational Studies as Topic; D039781:PubMed; D020127:Recovery of Function; D065287:Robotic Surgical Procedures / Q000009:adverse effects / Q000379:methods*