Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients
Robotic-assisted surgery is expected to have advantages over standard laparoscopic approach in patients undergoing curative surgery for rectal cancer. PubMed, Cochrane Library, Web of Science, Scopus and Google Scholar were searched from database inception to 10 November 2021, for both RCTs and obse...
| Main Authors: | , , , , , , , |
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| Format: | Article |
| Language: | English |
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MDPI AG
2021-12-01
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| Series: | Cancers |
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| Online Access: | https://www.mdpi.com/2072-6694/14/1/180 |
| _version_ | 1797499370372857856 |
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| author | Kamil Safiejko Radoslaw Tarkowski Maciej Koselak Marcin Juchimiuk Aleksander Tarasik Michal Pruc Jacek Smereka Lukasz Szarpak |
| author_facet | Kamil Safiejko Radoslaw Tarkowski Maciej Koselak Marcin Juchimiuk Aleksander Tarasik Michal Pruc Jacek Smereka Lukasz Szarpak |
| author_sort | Kamil Safiejko |
| collection | DOAJ |
| description | Robotic-assisted surgery is expected to have advantages over standard laparoscopic approach in patients undergoing curative surgery for rectal cancer. PubMed, Cochrane Library, Web of Science, Scopus and Google Scholar were searched from database inception to 10 November 2021, for both RCTs and observational studies comparing robotic-assisted versus standard laparoscopic surgery for rectal cancer resection. Where possible, data were pooled using random effects meta-analysis. Forty-Two were considered eligible for the meta-analysis. Survival to hospital discharge or 30-day overall survival rate was 99.6% for RG and 98.8% for LG (OR = 2.10; 95% CI: 1.00 to 4.43; <i>p</i> = 0.05). Time to first flatus in the RG group was 2.5 ± 1.4 days and was statistically significantly shorter than in LG group (2.9 ± 2.0 days; MD = −0.34; 95%CI: −0.65 to 0.03; <i>p</i> = 0.03). In the case of time to a liquid diet, solid diet and bowel movement, the analysis showed no statistically significant differences (<i>p</i> > 0.05). Length of hospital stay in the RG vs. LG group varied and amounted to 8.0 ± 5.3 vs. 9.5 ± 10.0 days (MD = −2.01; 95%CI: −2.90 to −1.11; <i>p</i> < 0.001). Overall, 30-days complications in the RG and LG groups were 27.2% and 19.0% (OR = 1.11; 95%CI: 0.80 to 1.55; <i>p</i> = 0.53), respectively. In summary, robotic-assisted techniques provide several advantages over laparoscopic techniques in reducing operative time, significantly lowering conversion of the procedure to open surgery, shortening the duration of hospital stay, lowering the risk of urinary retention, improving survival to hospital discharge or 30-day overall survival rate. |
| first_indexed | 2024-03-10T03:47:22Z |
| format | Article |
| id | doaj.art-72b4097eb2d541a39c2c74bc74b645c1 |
| institution | Directory Open Access Journal |
| issn | 2072-6694 |
| language | English |
| last_indexed | 2024-03-10T03:47:22Z |
| publishDate | 2021-12-01 |
| publisher | MDPI AG |
| record_format | Article |
| series | Cancers |
| spelling | doaj.art-72b4097eb2d541a39c2c74bc74b645c12023-11-23T11:17:23ZengMDPI AGCancers2072-66942021-12-0114118010.3390/cancers14010180Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 PatientsKamil Safiejko0Radoslaw Tarkowski1Maciej Koselak2Marcin Juchimiuk3Aleksander Tarasik4Michal Pruc5Jacek Smereka6Lukasz Szarpak7Colorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandDepartment of Surgical Oncology, Regional Specialist Hospital, 55-220 Legnica, PolandInstitute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, PolandColorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandColorectal Cancer Unit, Maria Sklodowska-Curie Bialystok Oncology Center, 15-027 Bialystok, PolandResearch Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, PolandResearch Unit, Polish Society of Disaster Medicine, 05-806 Warsaw, PolandInstitute of Outcomes Research, Maria Sklodowska-Curie Medical Academy, 03-411 Warsaw, PolandRobotic-assisted surgery is expected to have advantages over standard laparoscopic approach in patients undergoing curative surgery for rectal cancer. PubMed, Cochrane Library, Web of Science, Scopus and Google Scholar were searched from database inception to 10 November 2021, for both RCTs and observational studies comparing robotic-assisted versus standard laparoscopic surgery for rectal cancer resection. Where possible, data were pooled using random effects meta-analysis. Forty-Two were considered eligible for the meta-analysis. Survival to hospital discharge or 30-day overall survival rate was 99.6% for RG and 98.8% for LG (OR = 2.10; 95% CI: 1.00 to 4.43; <i>p</i> = 0.05). Time to first flatus in the RG group was 2.5 ± 1.4 days and was statistically significantly shorter than in LG group (2.9 ± 2.0 days; MD = −0.34; 95%CI: −0.65 to 0.03; <i>p</i> = 0.03). In the case of time to a liquid diet, solid diet and bowel movement, the analysis showed no statistically significant differences (<i>p</i> > 0.05). Length of hospital stay in the RG vs. LG group varied and amounted to 8.0 ± 5.3 vs. 9.5 ± 10.0 days (MD = −2.01; 95%CI: −2.90 to −1.11; <i>p</i> < 0.001). Overall, 30-days complications in the RG and LG groups were 27.2% and 19.0% (OR = 1.11; 95%CI: 0.80 to 1.55; <i>p</i> = 0.53), respectively. In summary, robotic-assisted techniques provide several advantages over laparoscopic techniques in reducing operative time, significantly lowering conversion of the procedure to open surgery, shortening the duration of hospital stay, lowering the risk of urinary retention, improving survival to hospital discharge or 30-day overall survival rate.https://www.mdpi.com/2072-6694/14/1/180rectal cancerrobotic-assisted laparoscopicconventional laparoscopic surgeryoutcomesystematic reviewmeta-analysis |
| spellingShingle | Kamil Safiejko Radoslaw Tarkowski Maciej Koselak Marcin Juchimiuk Aleksander Tarasik Michal Pruc Jacek Smereka Lukasz Szarpak Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients Cancers rectal cancer robotic-assisted laparoscopic conventional laparoscopic surgery outcome systematic review meta-analysis |
| title | Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients |
| title_full | Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients |
| title_fullStr | Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients |
| title_full_unstemmed | Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients |
| title_short | Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients |
| title_sort | robotic assisted vs standard laparoscopic surgery for rectal cancer resection a systematic review and meta analysis of 19 731 patients |
| topic | rectal cancer robotic-assisted laparoscopic conventional laparoscopic surgery outcome systematic review meta-analysis |
| url | https://www.mdpi.com/2072-6694/14/1/180 |
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