Robotic versus Laparoscopic Liver Resections for Colorectal Metastases: A Systematic Review and Meta-Analysis

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastroenterology

Background:

• Colorectal cancer frequently metastasizes to the liver, necessitating surgical intervention.
• Minimally invasive liver resection is increasingly utilized for liver metastases.
• Robotic-assisted liver resection (RLR) aims to improve upon laparoscopic liver resection (LRL).

Purpose of the Study:

• To systematically review and compare operative and short-term oncologic outcomes of LRL versus RLR for colorectal liver metastases.
• To conduct a meta-analysis of existing studies to evaluate the safety and efficacy of both surgical approaches.

Main Methods:

• Systematic review and meta-analysis of studies from PubMed, Embase, Scopus, and Cochrane databases.
• Inclusion of eight studies with a total of 3210 patients.
• Comparison of outcomes including conversion rates, mortality, complications, and hospital stay.

Main Results:

• RLR demonstrated a significantly lower conversion to open surgery rate (6.7%) compared to LRL (12.4%).
• No significant differences were found in 30-day mortality, individual complication rates, or length of hospital stay between LRL and RLR.
• While not statistically significant, 1-year, 2-year, and 3-year mortality rates appeared lower in the RLR group.

Conclusions:

• Laparoscopic and robotic liver resections for colorectal metastases are comparable in safety and short-term oncologic outcomes.
• Robotic surgery offers potential advantages, particularly in reducing conversion rates.
• Further research is needed to establish long-term survival benefits and increase the number of RLR cases.