Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis...

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Rectal cancer surgery traditionally uses laparoscopic techniques.
• Robotic-assisted surgery (RAS) is emerging as a potentially superior alternative.
• Comparative effectiveness of RAS versus standard laparoscopy for rectal cancer requires synthesis of current evidence.

Purpose of the Study:

• To systematically review and meta-analyze studies comparing robotic-assisted surgery (RAS) with standard laparoscopic surgery (LS) for rectal cancer resection.
• To evaluate key perioperative outcomes, including survival, recovery, and complications.

Main Methods:

• A comprehensive literature search was conducted across PubMed, Cochrane Library, Web of Science, Scopus, and Google Scholar up to November 10, 2021.
• Included were randomized controlled trials (RCTs) and observational studies comparing RAS and LS for rectal cancer.
• Data were pooled using random effects meta-analysis where possible.

Main Results:

• Forty-two studies were eligible for meta-analysis.
• Robotic-assisted surgery showed a statistically significant improvement in survival to hospital discharge or 30-day overall survival rate (OR = 2.10, p = 0.05).
• RAS significantly reduced length of hospital stay (MD = -2.01 days, p < 0.001) and time to first flatus (MD = -0.34 days, p = 0.03) compared to LS.

Conclusions:

• Robotic-assisted surgery demonstrates significant advantages over standard laparoscopic surgery for rectal cancer resection.
• Benefits include reduced operative time, lower conversion rates to open surgery, shorter hospital stays, and improved short-term survival.
• RAS is a promising approach for enhancing patient outcomes in rectal cancer treatment.