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Erschienen in: Journal of Cancer Research and Clinical Oncology 16/2023

14.08.2023 | Review

Comparison of robotic‑assisted versus conventional laparoscopic surgery for mid–low rectal cancer: a systematic review and meta-analysis

verfasst von: Qing Yao, Qian-Nan Sun, Jun Ren, Liu-Hua Wang, Dao-Rong Wang

Erschienen in: Journal of Cancer Research and Clinical Oncology | Ausgabe 16/2023

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Abstract

Purpose

Scarce research has reported the comparison between robotic and laparoscopic surgery in mid–low rectal cancer. Therefore, this meta-analysis is aimed to compare the safety and efficacy of the two surgical approaches.

Methods

A comprehensive search of the databases (PubMed, EMBASE, Cochrane, and Web of Science) was performed for studies comparing robotic and laparoscopic surgery. The outcomes of interest acquired from eight articles included three aspects: intraoperative conditions, postoperative status of patients, and complications. All data (robotic = 1350 patients, laparoscopic = 1330 patients) enrolled were analyzed using Rev Man 5.4.

Results

Compared to the laparoscopic group, the robotic group indicated a noticeable superiority in estimated blood loss (P < 0.0001), number of lymph nodes dissected (P = 0.004), time to first flatus (P = 0.001), time to first fluid diet (P = 0.001), hospital stay (P < 0.0001), conversion (P = 0.009), and urinary retention (P = 0.0006), but devoted much more operation time (P = 0.0004).

Conclusion

Robotic surgery was associated with superiority over laparoscopic surgery in increasing surgical safety, accelerating postoperative recovery, and reducing complications, which suggested that robotic surgery could be a safe and effective method for treating mid–low rectal cancer.
Literatur
Zurück zum Zitat Benson AB, Venook AP, Al-Hawary MM et al (2022) Rectal cancer, version 2.2022, NCCN Clinical practice guidelines in oncology. J Natl Compr Canc Netw 20(10):1139–1167CrossRefPubMed Benson AB, Venook AP, Al-Hawary MM et al (2022) Rectal cancer, version 2.2022, NCCN Clinical practice guidelines in oncology. J Natl Compr Canc Netw 20(10):1139–1167CrossRefPubMed
Zurück zum Zitat Bianchi PP, Ceriani C, Locatelli A et al (2010) Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomes. Surg Endosc 24(11):2888–2894CrossRefPubMed Bianchi PP, Ceriani C, Locatelli A et al (2010) Robotic versus laparoscopic total mesorectal excision for rectal cancer: a comparative analysis of oncological safety and short-term outcomes. Surg Endosc 24(11):2888–2894CrossRefPubMed
Zurück zum Zitat Feng Q, Yuan W, Li T et al (2022) Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol 7(11):991–1004CrossRefPubMed Feng Q, Yuan W, Li T et al (2022) Robotic versus laparoscopic surgery for middle and low rectal cancer (REAL): short-term outcomes of a multicentre randomised controlled trial. Lancet Gastroenterol Hepatol 7(11):991–1004CrossRefPubMed
Zurück zum Zitat Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1(8496):1479–1482CrossRefPubMed Heald RJ, Ryall RD (1986) Recurrence and survival after total mesorectal excision for rectal cancer. Lancet 1(8496):1479–1482CrossRefPubMed
Zurück zum Zitat Jayne D, Pigazzi A, Marshall H et al (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA 318(16):1569–1580CrossRefPubMedPubMedCentral Jayne D, Pigazzi A, Marshall H et al (2017) Effect of robotic-assisted vs conventional laparoscopic surgery on risk of conversion to open laparotomy among patients undergoing resection for rectal cancer: the ROLARR randomized clinical trial. JAMA 318(16):1569–1580CrossRefPubMedPubMedCentral
Zurück zum Zitat Kamali D, Reddy A, Imam S, Omar K, Jha A, Jha M (2017) Short-term surgical outcomes and patient quality of life between robotic and laparoscopic extralevator abdominoperineal excision for adenocarcinoma of the rectum. Ann R Coll Surg Engl 99(8):607–613CrossRefPubMedPubMedCentral Kamali D, Reddy A, Imam S, Omar K, Jha A, Jha M (2017) Short-term surgical outcomes and patient quality of life between robotic and laparoscopic extralevator abdominoperineal excision for adenocarcinoma of the rectum. Ann R Coll Surg Engl 99(8):607–613CrossRefPubMedPubMedCentral
Zurück zum Zitat Kim MJ, Park SC, Park JW et al (2018) Robot-assisted versus laparoscopic surgery for rectal cancer: a phase II open label prospective randomized controlled trial. Ann Surg 267(2):243–251CrossRefPubMed Kim MJ, Park SC, Park JW et al (2018) Robot-assisted versus laparoscopic surgery for rectal cancer: a phase II open label prospective randomized controlled trial. Ann Surg 267(2):243–251CrossRefPubMed
Zurück zum Zitat Law WL, Foo DCC (2017) Comparison of short-term and oncologic outcomes of robotic and laparoscopic resection for mid- and distal rectal cancer. Surg Endosc 31(7):2798–2807CrossRefPubMed Law WL, Foo DCC (2017) Comparison of short-term and oncologic outcomes of robotic and laparoscopic resection for mid- and distal rectal cancer. Surg Endosc 31(7):2798–2807CrossRefPubMed
Zurück zum Zitat Lee SH, Kim DH, Lim SW (2018) Robotic versus laparoscopic intersphincteric resection for low rectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 33(12):1741–1753CrossRefPubMed Lee SH, Kim DH, Lim SW (2018) Robotic versus laparoscopic intersphincteric resection for low rectal cancer: a systematic review and meta-analysis. Int J Colorectal Dis 33(12):1741–1753CrossRefPubMed
Zurück zum Zitat Li X, Wang T, Yao L et al (2017) The safety and effectiveness of robot-assisted versus laparoscopic TME in patients with rectal cancer: a meta-analysis and systematic review. Medicine (baltimore) 96(29):e7585CrossRefPubMed Li X, Wang T, Yao L et al (2017) The safety and effectiveness of robot-assisted versus laparoscopic TME in patients with rectal cancer: a meta-analysis and systematic review. Medicine (baltimore) 96(29):e7585CrossRefPubMed
Zurück zum Zitat Luca F, Craigg DK, Senthil M et al (2018) Sexual and urinary outcomes in robotic rectal surgery: review of the literature and technical considerations. Updates Surg 70(3):415–421CrossRefPubMed Luca F, Craigg DK, Senthil M et al (2018) Sexual and urinary outcomes in robotic rectal surgery: review of the literature and technical considerations. Updates Surg 70(3):415–421CrossRefPubMed
Zurück zum Zitat Moszkowicz D, Alsaid B, Bessede T et al (2011) Where does pelvic nerve injury occur during rectal surgery for cancer? Colorectal Dis 13(12):1326–1334CrossRefPubMed Moszkowicz D, Alsaid B, Bessede T et al (2011) Where does pelvic nerve injury occur during rectal surgery for cancer? Colorectal Dis 13(12):1326–1334CrossRefPubMed
Zurück zum Zitat Ng KT, Tsia AKV, Chong VYL (2019) Robotic versus conventional laparoscopic surgery for colorectal cancer: a systematic review and meta-analysis with trial sequential analysis. World J Surg 43(4):1146–1161CrossRefPubMed Ng KT, Tsia AKV, Chong VYL (2019) Robotic versus conventional laparoscopic surgery for colorectal cancer: a systematic review and meta-analysis with trial sequential analysis. World J Surg 43(4):1146–1161CrossRefPubMed
Zurück zum Zitat Panteleimonitis S, Ahmed J, Ramachandra M, Farooq M, Harper M, Parvaiz A (2017) Urogenital function in robotic vs laparoscopic rectal cancer surgery: a comparative study. Int J Colorectal Dis 32(2):241–248CrossRefPubMed Panteleimonitis S, Ahmed J, Ramachandra M, Farooq M, Harper M, Parvaiz A (2017) Urogenital function in robotic vs laparoscopic rectal cancer surgery: a comparative study. Int J Colorectal Dis 32(2):241–248CrossRefPubMed
Zurück zum Zitat Park JS, Lee SM, Choi GS et al (2023) Comparison of laparoscopic versus robot-assisted surgery for rectal cancers: the COLRAR randomized controlled trial. Ann Surg 278(1):31–38CrossRefPubMed Park JS, Lee SM, Choi GS et al (2023) Comparison of laparoscopic versus robot-assisted surgery for rectal cancers: the COLRAR randomized controlled trial. Ann Surg 278(1):31–38CrossRefPubMed
Zurück zum Zitat Qiu H, Yu D, Ye S, Shan R, Ai J, Shi J (2020) Long-term oncological outcomes in robotic versus laparoscopic approach for rectal cancer: a systematic review and meta-analysis. Int J Surg 80:225–230CrossRefPubMed Qiu H, Yu D, Ye S, Shan R, Ai J, Shi J (2020) Long-term oncological outcomes in robotic versus laparoscopic approach for rectal cancer: a systematic review and meta-analysis. Int J Surg 80:225–230CrossRefPubMed
Zurück zum Zitat Saklani AP, Lim DR, Hur H et al (2013) Robotic versus laparoscopic surgery for mid-low rectal cancer after neoadjuvant chemoradiation therapy: comparison of oncologic outcomes. Int J Colorectal Dis 28(12):1689–1698CrossRefPubMed Saklani AP, Lim DR, Hur H et al (2013) Robotic versus laparoscopic surgery for mid-low rectal cancer after neoadjuvant chemoradiation therapy: comparison of oncologic outcomes. Int J Colorectal Dis 28(12):1689–1698CrossRefPubMed
Zurück zum Zitat Serin KR, Gultekin FA, Batman B et al (2015) Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of short-term outcomes. J Robot Surg 9(3):187–194CrossRefPubMed Serin KR, Gultekin FA, Batman B et al (2015) Robotic versus laparoscopic surgery for mid or low rectal cancer in male patients after neoadjuvant chemoradiation therapy: comparison of short-term outcomes. J Robot Surg 9(3):187–194CrossRefPubMed
Zurück zum Zitat Stefanidis D, Wang F, Korndorffer JR Jr, Dunne JB, Scott DJ (2010) Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc 24(2):377–382CrossRefPubMed Stefanidis D, Wang F, Korndorffer JR Jr, Dunne JB, Scott DJ (2010) Robotic assistance improves intracorporeal suturing performance and safety in the operating room while decreasing operator workload. Surg Endosc 24(2):377–382CrossRefPubMed
Zurück zum Zitat Tang B, Gao GM, Zou Z et al (2020) Efficacy comparison between robot-assisted and laparoscopic surgery for mid-low rectal cancer: a prospective randomized controlled trial. Zhonghua Wei Chang Wai Ke Za Zhi 23(4):377–383PubMed Tang B, Gao GM, Zou Z et al (2020) Efficacy comparison between robot-assisted and laparoscopic surgery for mid-low rectal cancer: a prospective randomized controlled trial. Zhonghua Wei Chang Wai Ke Za Zhi 23(4):377–383PubMed
Zurück zum Zitat Wang X, Cao G, Mao W, Lao W, He C (2020) Robot-assisted versus laparoscopic surgery for rectal cancer: a systematic review and meta-analysis. J Cancer Res Ther 16(5):979–989CrossRefPubMed Wang X, Cao G, Mao W, Lao W, He C (2020) Robot-assisted versus laparoscopic surgery for rectal cancer: a systematic review and meta-analysis. J Cancer Res Ther 16(5):979–989CrossRefPubMed
Zurück zum Zitat Wee IJY, Kuo LJ, Ngu JC (2021) Urological and sexual function after robotic and laparoscopic surgery for rectal cancer: a systematic review, meta-analysis and meta-regression. Int J Med Robot 17(1):1–8CrossRefPubMed Wee IJY, Kuo LJ, Ngu JC (2021) Urological and sexual function after robotic and laparoscopic surgery for rectal cancer: a systematic review, meta-analysis and meta-regression. Int J Med Robot 17(1):1–8CrossRefPubMed
Zurück zum Zitat Yamanashi T, Miura H, Tanaka T et al (2023) Short-term outcomes of robot-assisted versus conventional laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiotherapy: a propensity score-matched analysis. J Robot Surg 17(3):959–969CrossRefPubMed Yamanashi T, Miura H, Tanaka T et al (2023) Short-term outcomes of robot-assisted versus conventional laparoscopic surgery for mid and low rectal cancer after neoadjuvant chemoradiotherapy: a propensity score-matched analysis. J Robot Surg 17(3):959–969CrossRefPubMed
Zurück zum Zitat Yamaoka Y, Shiomi A, Kagawa H et al (2022) Robotic surgery for clinical T4 rectal cancer: short- and long-term outcomes. Surg Endosc 36(1):91–99CrossRefPubMed Yamaoka Y, Shiomi A, Kagawa H et al (2022) Robotic surgery for clinical T4 rectal cancer: short- and long-term outcomes. Surg Endosc 36(1):91–99CrossRefPubMed
Metadaten
Titel
Comparison of robotic‑assisted versus conventional laparoscopic surgery for mid–low rectal cancer: a systematic review and meta-analysis
verfasst von
Qing Yao
Qian-Nan Sun
Jun Ren
Liu-Hua Wang
Dao-Rong Wang
Publikationsdatum
14.08.2023
Verlag
Springer Berlin Heidelberg
Erschienen in
Journal of Cancer Research and Clinical Oncology / Ausgabe 16/2023
Print ISSN: 0171-5216
Elektronische ISSN: 1432-1335
DOI
https://doi.org/10.1007/s00432-023-05228-6

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