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

We conducted a systematic review and meta-analysis to compare robotic versus open simultaneous resections for colorectal cancer and colorectal liver metastases.

On June 3, 2024, we searched on PubMed, Embase, and Cochrane. The eligibility criteria followed the PICO framework. The population included patients undergoing simultaneous resection of colorectal cancer and liver metastases. The intervention was robotic-assisted surgical resection, compared to open surgical resection as the control group. The outcomes were postoperative hospital stay, mortality, operative time, estimated intraoperative blood loss, intestinal anastomotic leakage, and bile leakage. Two authors independently extracted data regarding the characteristics of each study. We assess risk of bias using the ROBINS-I tool and RoB 2 tool.

We included 4 studies with 1,722 patients, of whom 210 (12.2%) underwent a robotic surgery approach. The intraoperative blood loss (mean difference [MD] -87.48 mL; 95% confidence interval [CI] [-103.76, -71.21]; P < .0001) and postoperative hospital stay (MD -2.13 days; 95% CI [-2.99, -1.27]; P < .0001) were significantly lower in patients treated by the robotic approach. Operative time was higher in the robotic surgery group (MD 48.87 minutes; 95% CI [21.23, 76.50]; P = .0005). The incidence of intestinal anastomotic leakage and bile leakage had no significant difference.

This study provides evidence that robotic approaches yield improved outcomes for patients undergoing simultaneous resection of colorectal cancer and liver metastases.