Robot-assisted versus conventional laparoscopic surgery for colorectal disease, focusing on rectal cancer: a meta-analysis
Annals of Surgical Oncology, 07/09/2012
Yang Y et al. – Robot–assisted laparoscopic surgery (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.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.
- 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.