Robotic versus Open for Simultaneous Surgery of Colorectal Cancer and Liver Metastases: A Meta-Analysis

Area of Science:

• Surgical Oncology
• Minimally Invasive Surgery
• Gastrointestinal Surgery

Background:

• Colorectal cancer with liver metastases often requires simultaneous surgical resection.
• Comparing surgical approaches is crucial for optimizing patient outcomes.
• Robotic-assisted surgery is an emerging alternative to traditional open procedures.

Purpose of the Study:

• To systematically review and meta-analyze studies comparing robotic versus open simultaneous resections for colorectal cancer and liver metastases.
• To evaluate the impact of surgical approach on key postoperative outcomes.

Main Methods:

• Systematic review and meta-analysis of studies identified through PubMed, Embase, and Cochrane databases.
• Inclusion criteria based on PICO framework: patients undergoing simultaneous resection for colorectal cancer and liver metastases.
• Data extraction and risk of bias assessment using ROBINS-I and RoB 2 tools.

Main Results:

• Included 4 studies with 1,722 patients; 12.2% underwent robotic surgery.
• Robotic approach significantly reduced intraoperative blood loss (MD -87.48 mL) and postoperative hospital stay (MD -2.13 days).
• Operative time was longer with robotic surgery (MD 48.87 minutes); no significant difference in anastomotic or bile leakage.

Conclusions:

• Robotic-assisted surgery demonstrates improved outcomes for simultaneous resection of colorectal cancer and liver metastases.
• The benefits include reduced blood loss and shorter hospital stays.
• Further research may explore long-term oncological outcomes.