Robotic rectal resection preserves anorectal function: Systematic review and meta-analysis

Area of Science:

• Colorectal Surgery
• Surgical Oncology
• Gastrointestinal Oncology

Background:

• Rectal cancer survival rates are improving, increasing focus on functional outcomes post-total mesorectal excision (TME).
• The Low Anterior Resection Syndrome (LARS) score quantifies postoperative anorectal dysfunction.
• This is the first meta-analysis comparing bowel function across open, laparoscopic, transanal, and robotic TME techniques.

Purpose of the Study:

• To compare postoperative anorectal function (LARS score) after different TME approaches.
• To evaluate the efficacy of robotic TME versus traditional methods for bowel function recovery.

Main Methods:

• A meta-analysis of 32 publications involving 5,565 patients.
• Inclusion of studies reporting functional outcomes using the LARS score.
• Comparison of functional outcomes with a consecutive series of robotic TME patients (n=48).

Main Results:

• Anorectal function recovery within one year was significantly better after robotic TME.
• Robotic TME showed superior outcomes compared to laparoscopic (p=0.006), open (p=0.002), and transanal (p=0.003) TME.
• Specific LARS scores indicated better function with robotic TME.

Conclusions:

• Robotic TME demonstrates superior recovery of anorectal function compared to other TME techniques.
• Further high-quality prospective studies are recommended to validate these findings.
• Robotic surgery may offer significant benefits for rectal cancer patients' functional outcomes.