Outcomes of Robot-Assisted Surgery in Rectal Cancer Compared with Open and Laparoscopic Surgery
Open Access
- 29 January 2023
- Vol. 15 (3), 839
- https://doi.org/10.3390/cancers15030839
Abstract
With increasing trends for the adoption of robotic surgery, many centers are considering changing their practices from open or laparoscopic to robot-assisted surgery for rectal cancer. We compared the outcomes of robot-assisted rectal resection with those of open and laparoscopic surgery. We searched Medline, Web of Science, and CENTRAL databases until October 2022. All randomized controlled trials (RCTs) and prospective studies comparing robotic surgery with open or laparoscopic rectal resection were included. Fifteen RCTs and 11 prospective studies involving 6922 patients were included. The meta-analysis revealed that robotic surgery has lower blood loss, less surgical site infection, shorter hospital stays, and higher negative resection margins than open resection. Robotic surgery also has lower conversion rates, lower blood loss, lower rates of reoperation, and higher negative circumferential margins than laparoscopic surgery. Robotic surgery had longer operation times and higher costs than open and laparoscopic surgery. There were no differences in other complications, mortality, and survival between robotic surgery and the open or laparoscopic approach. However, heterogeneity between studies was moderate to high in some analyses. The robotic approach can be the method of choice for centers planning to change from open to minimally invasive rectal surgery. The higher costs of robotic surgery should be considered as a substitute for laparoscopic surgery (PROSPERO: CRD42022381468).Keywords
Funding Information
- Champalimaud Clinical Center of Champalimaud Foundation
This publication has 75 references indexed in Scilit:
- Robotic versus Laparoscopic Proctectomy for Rectal Cancer: A Meta-analysisAnnals of Surgical Oncology, 2012
- Estudio prospectivo, aleatorizado: cirugía laparoscópica con asistencia robótica versus cirugía laparoscópica convencional en la resección del cáncer colorrectalCirugía Española, 2011
- Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-life short-term outcomes employing different treatment approachesInternational Journal of Colorectal Disease, 2011
- Robotic-Assisted versus Laparoscopic Surgery for Low Rectal Cancer: Case-Matched Analysis of Short-Term OutcomesAnnals of Surgical Oncology, 2010
- S052: a comparison of robot-assisted, laparoscopic, and open surgery in the treatment of rectal cancerSurgical Endoscopy, 2010
- Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomesSurgical Endoscopy, 2010
- Robotic tumor-specific mesorectal excison of rectal cancer: short-term outcome of a pilot randomized trialSurgical Endoscopy, 2008
- Laparoscopic Colon Surgery: Past, Present and FutureSurgical Clinics of North America, 2006
- Short-term endpoints of conventional versus laparoscopic-assisted surgery in patients with colorectal cancer (MRC CLASICC trial): multicentre, randomised controlled trialThe Lancet, 2005