Abstract
The aim of this meta-analysis was to comprehensively compare the safety and efficacy of robotic-assisted rectal cancer surgery (RRCS) and open rectal cancer surgery (ORCS). Electronic database (PubMed, EMBASE, Web of Knowledge, and the Cochrane Library) searches were conducted for all relevant studies that compared the short-term and long-term outcomes between RRCS and ORCS. Odds ratios (ORs), mean differences, and hazard ratios were calculated. Seven studies involving 1074 patients with rectal cancer were identified for this meta-analysis. Compared with ORCS, RRCS is associated with a lower estimated blood loss (mean difference [MD]: −139.98, 95% confidence interval [CI]: −159.11 to −120.86; P < 0.00001), shorter hospital stay length (MD: −2.10, 95% CI: −3.47 to −0.73; P = 0.003), lower intraoperative transfusion requirements (OR: 0.52, 95% CI: 0.28 to 0.99, P = 0.05), shorter time to flatus passage (MD: −0.97, 95% CI = −1.06 to −0.88, P < 0.00001), and shorter time to resume a normal diet (MD: −1.71.95% CI = −3.31 to −0.12, P = 0.04). There were no significant differences in surgery-related complications, oncologic clearance, disease-free survival, and overall survival between the two groups. However, RRCS was associated with a longer operative time. RRCS is safe and effective.
Highlights
R Systematic Reviews and Meta-Analyses (PRISMA) statement[17]
The study inclusion criteria were as follows: (1) the study was a comparative study that compared the safety and efficiency between robotic rectal cancer surgery (RRCS) and open rectal cancer surgery (ORCS); (2) the study included quantitative outcome data; (3) if the same institution and/or authors reported several studies, only the study with the greatest patient population or the highest quality study was included in the analysis; and (4) the study was published in English
Three studies were excluded according to the inclusion criteria[19,20,21], leaving 7 studies that were included in our analysis[22,23,24,25,26,27,28]
Summary
R Systematic Reviews and Meta-Analyses (PRISMA) statement[17]. A comprehensive literature search was carried out by reviewers using the following electronic databases: PubMed, EMBASE, Web of Knowledge, and the Cochrane Library. The search was conducted in July 2014, and the language was restricted to English. The following search terms were used: robot or robotic or robot-assisted or da vinci or davinci, open, rectal or rectum or colorectal, and cancer or tumor or carcinoma
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