title: Robotic versus laparoscopic low anterior resection for rectal cancer: a meta-analysis.
abstract: BACKGROUND
  The objective of this meta-analysis was to compare the clinical and oncologic outcomes of robotic low anterior resection (R-LAR) with conventional laparoscopic low anterior resection (L-LAR).
  
  
  METHODS
  A search in the MEDLINE, Embase, and Ovid databases was performed for studies published before July 2014 that compared the clinical and oncologic outcomes of R-LAR and L-LAR. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, a fixed or random effects model was used for the meta-analysis. The clinical and oncologic outcomes evaluated included operative time, estimated blood loss, length of hospital stay, rate of conversion to open surgery, post-operative complications, circumferential margin status, and number of lymph nodes collected.
  
  
  RESULTS
  Eight studies, including 324 R-LAR cases and 268 conventional L-LAR cases, were analyzed. The meta-analysis showed that R-LAR was associated with a shorter hospital stay (mean difference (MD) = -1.03; 95% confidence interval (CI) = -1.78, -0.28; P = 0.007), lower conversion rate (odds ratio (OR) = 0.08; 95% CI = 0.02, 0.31; P = 0.0002), lower rate of circumferential margin involvement (OR = 0.5; 95% CI = 0.25, 1.01; P = 0.05), and lower overall complication rate (MD = 0.65; 95% CI = 0.43, 0.99; P = 0.04) compared with L-LAR. There was no difference in operative time (MD = 28.4; 95% CI = -3.48, 60.27; P = 0.08), the number of lymph nodes removed (MD = -0.63; 95% CI = -0.78, 2.05; P = 0.38), and days to return of bowel function (MD = -0.15; 95% CI = -0.37, 0.06; P = 0.17).
  
  
  CONCLUSIONS
  R-LAR was shown to be associated with a shorter hospital stay, lower conversion rate, lower rate of circumferential margin involvement, and lower overall complication rate compared with L-LAR. There were no differences in operative time, the number of lymph nodes removed, and days to return of bowel function.
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. sunyanlai@126.com.
authors.forename: Yanlai
authors.initials: Y
authors.lastname: Sun
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. xuhuirong676@163.com.
authors.forename: Huirong
authors.initials: H
authors.lastname: Xu
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. lizengjun676@163.com.
authors.forename: Zengjun
authors.initials: Z
authors.lastname: Li
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. handoctor@139.com.
authors.forename: Jianjun
authors.initials: J
authors.lastname: Han
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. songwentao676@126.com.
authors.forename: Wentao
authors.initials: W
authors.lastname: Song
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. wangjunwei676@126.com.
authors.forename: Junwei
authors.initials: J
authors.lastname: Wang
authors.affiliation: Department of Colorectal Cancer Surgery, Shandong Cancer Hospital and Institute, 440 Jiyan Road, Jinan, 250117, China. xzfa2216@163.com.
authors.forename: Zhongfa
authors.initials: Z
authors.lastname: Xu
mesh_terms: D006801:Humans; D010535:Laparoscopy / Q000379:methods*; D007902:Length of Stay; D011183:Postoperative Complications; D011379:Prognosis; D012004:Rectal Neoplasms / Q000601:surgery*; D012371:Robotics / Q000379:methods*