Robot-assisted versus laparoscopic short- and long-term outcomes in complete mesocolic excision for right-sided colonic cancer: a systematic review and meta-analysis

Cuk, Pedja; Jawhara, Mohamad; Al‐Najami, Issam; Helligsø, Per; Pedersen, Andreas Kristian; Ellebæk, Mark Bremholm

doi:10.1007/s10151-022-02686-x

Cited by 9 publications

(15 citation statements)

References 71 publications

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“…Twenty-three reviews on colectomy were included [30,31,37,[39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56][57][58]. Of the twentythree reviews, two were systematic reviews [30,57], eighteen were meta-analyses [31,37,39,40,[42][43][44][45][46][47][49][50][51][52][53]55,56,58], and three were network meta-analyses [41,48,54]. The corrected covered area of the 23 reviews was 2.6% (slight overlap).…”

Section: Colectomymentioning

confidence: 99%

“…Within colectomy, multiple indications for surgery and surgical procedures exist. Regarding the indications for surgery, thirteen reviews included colorectal cancer surgery studies only [30,31,41,[43][44][45][46][47][48]54,55,57,58], two reviews focused on resections indicated by diverticular diseases [39,42], and the remaining seven reviews included studies related to colectomy for any or multiple indications [37,40,[49][50][51][52][53]. As for the surgical procedures themselves, nine studies focused on left or right hemicolectomy [50][51][52][53][54][55][56][57][58], four on total mesorectal excisions [31,[46][47][48], two on complete mesocolic excisions [30,45], three on colorectal resections [41,43,44], two on diverticular resections [39,42], and three on multiple surgical procedures related to the colon [37,40,49]<...…”

Section: Colectomymentioning

confidence: 99%

“…Qualitative data were retrieved from two systematic reviews [30,57] and one metaanalysis [45]. Although this meta-analysis analysed clinical outcomes that were not included in this umbrella review, it did systematically review some clinical outcomes that were of interest [45]. These and the findings from [30,57] are summarized in Table A3.…”

Section: Colectomymentioning

confidence: 99%

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A Comparison of Clinical Outcomes of Robot-Assisted and Conventional Laparoscopic Surgery

Chabot,

Calleja-Agius,

Horeman

2024

Surgical Techniques Development

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Background: Although robot-assisted laparoscopic surgery has become more in popular, it remains unclear what clinical advantages it offers over conventional laparoscopic surgery. Objective: This (systematic) umbrella review aims to synthesize and compare the clinical outcomes of robot-assisted laparoscopic surgery versus conventional laparoscopic surgery. Methods: A systematic literature search was conducted in PubMed and Scopus. All systematic reviews and meta-analyses published in the past five years that compared the clinical outcomes for cholecystectomy, colectomy, hysterectomy, nephrectomy, and/or prostatectomy were included. The quality of all included reviews was assessed with the AMSTAR 2 quality assessment tool. Each review’s study characteristics and primary sources were extracted, along with the quantitative and qualitative data for blood loss, rate of conversion to open surgery, hospitalization costs, incisional hernia rate, intraoperative complication rate, postoperative complication rate, length of hospital stay, operative time, readmission rate, and wound infection. Results: Fifty-two systematic reviews and (network) meta-analyses were included in this umbrella review, covering more than 1,288,425 patients from 1046 primary sources published between 1996 and 2022. The overall quality of the included reviews was assessed to be low or critically low. Robot-assisted laparoscopic surgery yielded comparable results to conventional laparoscopic surgery in terms of blood loss, conversion to open surgery rate, intraoperative complication rate, postoperative complication rate, readmission rate, and wound infection rate for most surgical procedures. While the hospitalization costs of robot-assisted laparoscopic surgery were higher and the operative times of robot-assisted laparoscopic surgery were longer than conventional laparoscopic surgery, robot-assisted laparoscopic surgery reduced the length of hospital stay of patients in nearly all cases. Conclusion: Robot-assisted laparoscopic surgery achieved comparable results with conventional laparoscopic surgery for cholecystectomy, colectomy, hysterectomy, nephrectomy, and prostatectomy based on ten clinical outcomes.

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Section: Colectomymentioning

confidence: 99%

Section: Colectomymentioning

confidence: 99%

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A Comparison of Clinical Outcomes of Robot-Assisted and Conventional Laparoscopic Surgery

Chabot,

Calleja-Agius,

Horeman

2024

Surgical Techniques Development

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“…Complete mesocolic excision (CME) with central vascular ligation (CVL) for colonic cancer was first described by Hohenberger et al [ 47 ] and has been shown to have better quality surgical specimens and is associated with superior long term oncological outcomes[ 48 ]. The superior optics, stable retraction and dexterous dissection provided by the robotic platform makes it well suited to perform CME and CVL safely[ 49 ].…”

Section: Surgical Outcomes Of Racs In the Elderlymentioning

confidence: 99%

Robotic surgery in elderly patients with colorectal cancer: Review of the current literature

Teo¹,

Ngu²

2023

World J Gastrointest Surg

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With an ageing global population, we will see an increasing number of elderly patients with colorectal cancer (CRC) requiring surgery. However, it should be recognized that the elderly are a heterogenous group, with varying physiological and functional status. While traditionally viewed to be associated with frailty, comorbidities, and a higher risk of post operative morbidity, the advancements in minimally invasive surgery (MIS) and improvements in perioperative care have allowed CRC surgery to be safe and feasible in the elderly - chronological age alone should therefore not strictly be an exclusion criterion for curative surgery. However, as a form of MIS, laparoscopic assisted colorectal surgery (LACS) has the inherent disadvantages of: (1) Dependence on a trained assistant for retraction and laparoscope control; (2) The loss of wristed movement with reduced dexterity and suboptimal ergonomics; (3) A lack of intuitive movement due to the levering effect of trocars; and (4) An amplification of physiological tremors. Representing a technical evolution of LACS, robotic assisted colorectal surgery was introduced to overcome these limitations. In this minireview, we examine the evidence for robotic surgery in the elderly with CRC.

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“…Además, los estudios randomizados al respecto comprueban su factibilidad y seguridad comparado con la resección convencional 11 . Otras revisiones sistemáticas y metaanálisis en base a estudios retrospectivos comprueban que la técnica puede ser ejecutada de manera segura por vía tanto abierta como laparoscópica y robótica en manos de grupos experimentados 12 .…”

Section: Introductionunclassified

Resultados perioperatorios de la implementación de la resección completa del mesocolon por vía laparoscópica en cáncer de colon derecho y transverso

Vela Ulloa,

Urrejola Schmied,

Molina Pezoa

et al. 2024

Rev Cir.

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Introducción: La técnica de resección completa del mesocolon (RCM) en la hemicolectomía derecha consiste en la disección por planos embriológicos para lograr la resección completa del envoltorio mesocolónico, además de una ligadura vascular central (LVC) con linfadenectomía D3, que no se realiza normalmente con la técnica estándar. Esta técnica se asocia a mejores resultados de sobrevida global y libre de enfermedad que la cirugía convencional en trabajos retrospectivos. Sin embargo, no existen datos de su implementación a nivel nacional. El objetivo de este estudio es evaluar los resultados perioperatorios de la implementación del RCM en un centro universitario en nuestro medio.Materiales y Método: Estudio retrospectivo de cohorte de pacientes consecutivos sometidos a hemicolectomía derecha laparoscópica con técnica de RCM-LVC entre Enero 2022 y Junio 2023. Se recopilaron variables demográficas, perioperatorias, postoperatorias e histopatológicas. Los resultados se analizaron utilizando estadística descriptiva.Resultados: En el periodo, 29 pacientes se sometieron a RCM laparoscópica (mediana de edad 66(57-76) y 15(52%) sexo femenino). La mediana del tiempo quirúrgico fue 202,9 minutos. No hubo casos de conversión, filtración anastomótica, ni mortalidad. Hubo morbilidad en 9 casos (31%) y de estos solo 1(3,4%) fue Clavien-Dindo III (hematoma Pfannenstiel reintervenido). No hubo lesiones vasculares intraoperatorias. Mediana de hospitalización de 3 días. Doce casos (41%) eran etapa II y 8(28%) etapa III. La mediana de linfonodos resecados fue 23(18-28).Conclusión: Esta serie demuestra que la implementación de la RCM-LVC por vía laparoscópica para el tratamiento del cáncer de colon derecho y transverso es factible en centros con experiencia en cirugía colorrectal laparoscópica avanzada.

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Robot-assisted versus laparoscopic short- and long-term outcomes in complete mesocolic excision for right-sided colonic cancer: a systematic review and meta-analysis

Cited by 9 publications

References 71 publications

A Comparison of Clinical Outcomes of Robot-Assisted and Conventional Laparoscopic Surgery

A Comparison of Clinical Outcomes of Robot-Assisted and Conventional Laparoscopic Surgery

Robotic surgery in elderly patients with colorectal cancer: Review of the current literature

Resultados perioperatorios de la implementación de la resección completa del mesocolon por vía laparoscópica en cáncer de colon derecho y transverso

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