Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients

Safiejko, Kamil; Tarkowski, Radosław; Koselak, Maciej; Juchimiuk, Marcin; Tarasik, Aleksander; Pruc, Michał; Smereka, Jacek; Szarpak, Łukasz

doi:10.3390/cancers14010180

Cited by 52 publications

(36 citation statements)

References 63 publications

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“…In contrast to previous published meta-analyses [18,26,27], our data do not show a significant difference regarding hospital stay, which could be explained by the fact that time to first flatus is in general faster in laparoscopy [3], and bowel obstruction is a rare complication after minimally invasive procedures, independently of either laparoscopic or robotic-assisted techniques. Another important outcome of this study should be interpreted with caution: significantly more defunctioning stomas were created in the RR group (LR Group: 16 (32%) vs. RR Group: 39 (55.7%), p = 0.006), which was also significant in the PSM.…”

Section: Discussioncontrasting

confidence: 99%

“…A mercury score of 1 (good) was achieved in the majority of the resected specimens in both groups (LR Group: 86.67% vs. RR Group: 88.14%), and a score of 3 (bad) was observed only in two laparoscopic cases (3.33%). The number of retrieved lymph nodes did not differ between groups (LR Group: 22 (16-27) vs. 24 (15)(16)(17)(18)(19)(20)(21)(22)(23)(24)(25)(26)(27)(28)(29)(30), p = 0.512). Oncological findings are shown in Table 3.…”

Section: Resultsmentioning

confidence: 87%

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Is Robotic Assisted Colorectal Cancer Surgery Equivalent Compared to Laparoscopic Procedures during the Introduction of a Robotic Program? A Propensity-Score Matched Analysis

Tschann

Weigl

Lechner

et al. 2022

Cancers

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Background: Robotic surgery represents a novel approach for the treatment of colorectal cancers and has been established as an important and effective method over the last years. The aim of this work was to evaluate the effect of a robotic program on oncological findings compared to conventional laparoscopic surgery within the first three years after the introduction. Methods: All colorectal cancer patients from two centers that either received robotic-assisted or conventional laparoscopic surgery were included in a comparative study. A propensity-score-matched analysis was used to reduce confounding differences. Results: A laparoscopic resection (LR Group) was performed in 82 cases, and 93 patients were treated robotic-assisted surgery (RR Group). Patients’ characteristics did not differ between groups. In right-sided resections, an intracorporeal anastomosis was significantly more often performed in the RR Group (LR Group: 5 (26.31%) vs. RR Group: 10 (76.92%), p = 0.008). Operative time was shown to be significantly shorter in the LR Group (LR Group: 200 min (150–243) vs. 204 min (174–278), p = 0.045). Conversions to open surgery did occur more often in the LR Group (LR Group: 16 (19.51%) vs. RR Group: 5 (5.38%), p = 0.004). Postoperative morbidity, the number of harvested lymph nodes, quality of resection and postoperative tumor stage did not differ between groups. Conclusion: In this study, we could clearly demonstrate robotic-assisted colorectal cancer surgery as effective, feasible and safe regarding postoperative morbidity and oncological findings compared to conventional laparoscopy during the introduction of a robotic system.

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Section: Discussioncontrasting

confidence: 99%

Section: Resultsmentioning

confidence: 87%

Is Robotic Assisted Colorectal Cancer Surgery Equivalent Compared to Laparoscopic Procedures during the Introduction of a Robotic Program? A Propensity-Score Matched Analysis

Tschann

Weigl

Lechner

et al. 2022

Cancers

View full text Add to dashboard Cite

show abstract

“…Baek et al also stated a significant difference in the duration of hospital stay postoperatively, favoring the robotic group (nine vs 11 days, P = 0.01) [26]. Another meta-analysis, by Safiejko et al, also observed a significant difference between the two groups [29]. However, the data were highly heterogeneous (I 2 = 99%) [29].…”

Section: Primary Outcomesmentioning

confidence: 97%

“…Another meta-analysis, by Safiejko et al, also observed a significant difference between the two groups [29]. However, the data were highly heterogeneous (I 2 = 99%) [29]. A shorter length of hospital stay is associated with enhanced recovery after surgery and diminished financial burden.…”

Section: Primary Outcomesmentioning

confidence: 99%

Comparison of Non-Oncological Postoperative Outcomes Following Robotic and Laparoscopic Colorectal Resection for Colorectal Malignancy: A Systematic Review and Meta-Analysis

Ravindra¹,

Igweonu-Nwakile²,

Ali³

et al. 2022

Cureus

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The objective of this systematic review and meta-analysis is to compare the postoperative outcomes of robotic and laparoscopic colorectal resection for colorectal malignancy. We performed a systematic review using a comprehensive search strategy on several electronic databases (PubMed, PubMed Central, Medline, and Google Scholar) in April 2022. Postoperative outcomes of robotic versus laparoscopic surgery for colorectal cancer were compared using 12 end points. Observational studies, randomized controlled trials, and nonrandomized clinical trials comparing robotic and laparoscopic resection for colorectal cancer were included. The statistical analysis was performed using the risk ratio (RR) for categorical variables and the standardized mean differences (SMD) for continuous variables. Sixteen studies involving 2,318 patients were included. The difference in length of hospital stay was significantly shorter with robotic access (SMD = -0.10, 95% CI = -0.19, -0.01, P = 0.04, I 2 = 0%). Regarding intra-abdominal abscesses, the analysis showed an advantage in favor of the robotic group, but the result was not statically significant (RR = 0.54, 95% CI = 0.28, 1.05, P = 0.07, I 2 = 0%). Mechanical obstruction was found to be higher in robotic group, favoring laparoscopic access, but was not significant (RR = 1.91, 95% CI = 0.95, 3.83, P = 0.07, I 2 = 0%). There was no difference in time to pass flatus and consume a soft diet. The rates of anastomotic leakage, ileus, wound infection, readmission, mortality, and incisional hernias were similar with both approaches. Robotic surgery for colorectal cancer is associated with a shorter hospital stay, with no differences in mortality and postoperative morbidity.

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“…Surgery is a standard treatment procedure for CRC, particularly for stage 0 to stage II [ 30 , 31 ]. Other stages required adjuvant therapy or chemotherapy and targeted therapy besides the surgery.…”

Section: Cancer Drug Resistance and Its Challengesmentioning

confidence: 99%

Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies

Hossain

Karuniawati

Jairoun

et al. 2022

Cancers

319

152

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Colorectal cancer (CRC) is the second most deadly cancer. Global incidence and mortality are likely to be increased in the coming decades. Although the deaths associated with CRC are very high in high-income countries, the incidence and fatalities related to CRC are growing in developing countries too. CRC detected early is entirely curable by surgery and subsequent medications. However, the recurrence rate is high, and cancer drug resistance increases the treatment failure rate. Access to early diagnosis and treatment of CRC for survival is somewhat possible in developed countries. However, these facilities are rarely available in developing countries. Highlighting the current status of CRC, its development, risk factors, and management is crucial in creating public awareness. Therefore, in this review, we have comprehensively discussed the current global epidemiology, drug resistance, challenges, risk factors, and preventive and treatment strategies of CRC. Additionally, there is a brief discussion on the CRC development pathways and recommendations for preventing and treating CRC.

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Robotic-Assisted vs. Standard Laparoscopic Surgery for Rectal Cancer Resection: A Systematic Review and Meta-Analysis of 19,731 Patients

Cited by 52 publications

References 63 publications

Is Robotic Assisted Colorectal Cancer Surgery Equivalent Compared to Laparoscopic Procedures during the Introduction of a Robotic Program? A Propensity-Score Matched Analysis

Is Robotic Assisted Colorectal Cancer Surgery Equivalent Compared to Laparoscopic Procedures during the Introduction of a Robotic Program? A Propensity-Score Matched Analysis

Comparison of Non-Oncological Postoperative Outcomes Following Robotic and Laparoscopic Colorectal Resection for Colorectal Malignancy: A Systematic Review and Meta-Analysis

Colorectal Cancer: A Review of Carcinogenesis, Global Epidemiology, Current Challenges, Risk Factors, Preventive and Treatment Strategies

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