Robotic Versus Laparoscopic Minimally Invasive Surgery for Rectal Cancer: A Systematic Review and Meta-analysis of...

Area of Science:

• Minimally invasive surgery
• Surgical oncology
• Robotic surgery

Background:

• Robotic surgery (RS) offers technological advantages for precise dissection in confined spaces.
• Evidence for RS in rectal cancer primarily relies on observational data.
• Randomized controlled trials (RCTs) are needed to compare RS with conventional laparoscopic surgery (LS).

Purpose of the Study:

• To evaluate the safety and efficacy of robotic surgery versus conventional laparoscopic surgery for elective rectal resection in adults with rectal cancer.

Main Methods:

• A systematic review and meta-analysis of RCTs comparing RS and LS for rectal cancer.
• Searched MEDLINE, Embase, and CENTRAL databases (until August 2016).
• Evaluated endpoints included margin status, lymph nodes harvested, conversion rates, complications, and operative time.

Main Results:

• Five RCTs (334 RS, 337 LS) were included.
• RS was associated with a lower conversion rate (7.3%) compared to LS (P = 0.04).
• RS had a significantly longer operative time (MD 38.43 minutes, P < 0.00001).
• Perioperative mortality, margin involvement, and lymph node yield were similar between groups.

Conclusions:

• Moderate-quality evidence suggests RS provides comparable oncologic outcomes to LS for rectal cancer.
• RS demonstrates a reduced rate of conversion to open surgery.
• The primary drawback of RS is its significantly longer operative time.