Robotic and robotic-assisted vs Laparoscopic rectal cancer surgery: A meta-analysis of short-term and long-term results

Abstract

The usage of robotic surgery in rectal cancer (RC) is increasing, but there is an ongoing debate as to whether it provides any benefit. This study conducted a meta-analysis of rectal cancer surgery for short-term and long-term outcome by Robotic and robotic-assisted surgery (RS) vs laparoscopic surgery (LS).Pubmed, Embase, Ovid, CNKI, Cochrane Library and Web of Science databases were searched. Studies clearly documenting a comparison of short-term and long-term effect between RS and LS for RC were selected. Lymph node harvested, operation time, hospital stay, circumferential resection margins（CRM), complications, 3-year disease-free survival (DFS) and 5-year DFS parameters were evaluated. All data were performed by Review Manager 5.3 software. Nine studies were collected that included 1436 cases in total, 716 (49.86%) in the RS group, 720(50.14%) in the LS group. Compared with LS, RS was associated with longer operation time (MD 35.19, 95%CI [7.57, 62.81]; P = 0.01), but similar hospital stay (MD -0.43, 95%CI [-0.87,0.01]; P = 0.05).Lymph node harvested, CRM, complications, 3-year DFS, 5-year DFS had no significance difference between RS and LS groups（MD -0.67，95%CI[-1.53，0.19]；P = 0.13；MD 0.86，95%CI[0.54,1.37]；P = 0.52；MD 0.97，95%CI [0.73,1.29]；P = 0.86；MD 0.94，95%CI[0.60,1.48]；P = 0.79；MD 0.88，95%CI[0.52,1.47]；P = 0.61 respectively）.RS is feasible and safe for RC. It has an advantage in short -term outcome and a similar effect in long-term outcome compared with LS.