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Robotic versus laparoscopic left colectomy: a systematic review and meta-analysis
Leonardo Solaini1,2, Antonio Bocchino3, Andrea Avanzolini4
1Department of Medical and Surgical Sciences (DIMEC), University of Bologna, Bologna, Italy. leonardo.solaini2@unibo.it.
International Journal of Colorectal Disease
|June 1, 2022
Summary
Robotic left colectomy shows lower conversion rates and fewer complications than laparoscopic surgery. However, operative times are longer, and benefits for malignancies were not confirmed.
Area of Science:
- Minimally Invasive Surgery
- Surgical Oncology
- Colorectal Surgery
Background:
- The efficacy of robotic surgery in left colectomy remains under investigation.
- Evidence comparing robotic left colectomy (RLC) to laparoscopic left colectomy (LLC) needs systematic review.
Purpose of the Study:
- To evaluate the safety and efficacy of robotic left colectomy compared to laparoscopic left colectomy.
- To synthesize current evidence on patient outcomes for RLC versus LLC.
Main Methods:
- Systematic review of comparative studies (2004-2022) from Web of Science, PubMed, and Scopus.
- Inclusion criteria: RLC vs. LLC with ≥20 patients in the robotic arm.
- Random-effect model used for pooled analysis; Newcastle-Ottawa Scale for quality assessment.
Main Results:
- 11 studies with 52,589 patients (13,506 RLC, 39,083 LLC) were included.
- RLC demonstrated significantly lower conversion rates (RR 0.5) and fewer overall complications (RR 0.9), anastomotic leaks (RR 0.7), and wound infections (RR 3.1).
- RLC had longer operative times (WMD 39.1 min) but similar mortality rates (RR 1.1). No significant differences in postoperative variables for malignancies.
Conclusions:
- Robotic left colectomy offers advantages in reduced conversion rates and postoperative morbidity compared to the laparoscopic approach.
- While RLC shows promise for lower complication rates, these benefits were not consistently observed in procedures for malignancies.
- Further research may clarify the specific indications and long-term outcomes of robotic left colectomy.
