A Pooled Analysis of Robotic Versus Laparoscopic Surgery for Colon Cancer

An increasing number of studies have been reported since the "Da Vinci" Robotic System was used in gastrointestinal disease. Thus, we conducted this meta-analysis to evaluate the safety and efficacy of robotic colectomy (RC) compared with laparoscopic colectomy (LC) in the treatment of colon cancer.

A systematic search of Medline, Embase databases, and the Cochrane Library was performed to identify studies that compared RC and LC and were published up to February 2015. The methodological quality of the selected studies was assessed. Depending on statistical heterogeneity, the fixed or the random-effect model was used for the meta-analysis. Outcomes of interest included the operating time, blood loss, the length of hospital stay, conversion rates to open, postoperative complications, and related outcomes were evaluated.

Fourteen studies were included in the meta-analysis. These studies involved a total of 125,989 patients: 4924 of them underwent RC and 121,055 underwent LC. The meta-analysis showed that the RC group had a longer operating time (P<0.01), lower blood loss (P<0.01), lower intraoperative conversion to open rate (P<0.01), shorter hospital stay (P<0.01), lower postoperative complication rate (P<0.01), and significantly faster bowel function recovery (P<0.01). There were no differences in the number of lymph nodes harvested (P>0.05).

Our data suggest that RC may be a safe, feasible, and minimally invasive alternative to its LC counterpart when performed by experienced surgeons in selected patients. However, the long-term outcomes between the 2 techniques need to be further examined.