Robotic versus conventional laparoscopic surgery for rectal cancer: systematic review and meta-analysis

Lee, Seon Heui; Lim, Sungwon; Kim, Jin Hee; Lee, Kil Yeon

doi:10.4174/astr.2015.89.4.190

Cited by 71 publications

(58 citation statements)

References 50 publications

(91 reference statements)

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“…There are only a few studies whose data were homogeneous enough to permit a meta-analysis. However, this has already been performed by two previous systematic reviews[46,47] which combined the data of three studies. We discuss these systematic reviews in our discussion.…”

Section: Resultsmentioning

confidence: 99%

“…Nevertheless, it should be mentioned that two review articles have performed meta-analyses on male urological and sexual function scores of patients receiving robotic vs laparoscopic rectal surgery[46,47]. For male urological function, the reviews pooled the data from three studies and found that at 3 mo there was a significant difference of IPSS scores in favour of the robotic group.…”

Section: Discussionmentioning

confidence: 99%

“…For male urological function, the reviews pooled the data from three studies and found that at 3 mo there was a significant difference of IPSS scores in favour of the robotic group. However, this was not the case at 6 mo following surgery and at 12 mo the two meta-analyses reported contradictory results, one showing favourable IPSS scores for the robotic group[46] whilst the other demonstrated no difference between the two groups[47]. Regarding male sexual function, the meta-analyses pooled the data for erectile function only.…”

Section: Discussionmentioning

confidence: 99%

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Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery

Panteleimonitis

Ahmed

Harper

et al. 2016

WJGS

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AIMTo analyses the current literature regarding the urogenital functional outcomes of patients receiving robotic rectal cancer surgery.METHODSA comprehensive literature search of electronic databases was performed in October 2015. The following search terms were applied: “rectal cancer” or “colorectal cancer” and robot* or “da Vinci” and sexual or urolog* or urinary or erect* or ejaculat* or impot* or incontinence. All original studies examining the urological and/or sexual outcomes of male and/or female patients receiving robotic rectal cancer surgery were included. Reference lists of all retrieved articles were manually searched for further relevant articles. Abstracts were independently searched by two authors.RESULTSFifteen original studies fulfilled the inclusion criteria. A total of 1338 patients were included; 818 received robotic, 498 laparoscopic and 22 open rectal cancer surgery. Only 726 (54%) patients had their urogenital function assessed via means of validated functional questionnaires. From the included studies, three found that robotic rectal cancer surgery leads to quicker recovery of male urological function and five of male sexual function as compared to laparoscopic surgery. It is unclear whether robotic surgery offers favourable urogenital outcomes in the long run for males. In female patients only two studies assessed urological and three sexual function independently to that of males. In these studies there was no difference identified between patients receiving robotic and laparoscopic rectal cancer surgery. However, in females the presented evidence was very limited making it impossible to draw any substantial conclusions.CONCLUSIONThere seems to be a trend towards earlier recovery of male urogenital function following robotic surgery. To evaluate this further, larger well designed studies are required.

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Section: Resultsmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Critical analysis of the literature investigating urogenital function preservation following robotic rectal cancer surgery

Panteleimonitis

Ahmed

Harper

et al. 2016

WJGS

View full text Add to dashboard Cite

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“…A recent case-controlled analysis comparing TME between robotic and laparoscopic methods did not show any significant difference in the amount of blood loss (30). A separate meta-analysis review reaffirmed these findings (31).…”

Section: Estimated Blood Lossmentioning

confidence: 88%

A review on robotic surgery in rectal cancer

Azman

Kim

2016

Transl. Gastroenterol. Hepatol.

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Robotic surgery has the upper hand when compared to the laparoscopic approach in terms of superior visualisation, flexibility in movement, steadiness and accessibility to confined anatomical spaces.Nevertheless, limitations still exist with regards to cost, reduced tactile sensation, time-consuming setup and a significant learning curve to achieve. Although studies have shown better or at least comparable outcomes between the robotic and laparoscopic approach, the limitations mentioned result in poor penetrance among centres and surgeons. Advancements in robotic surgery technology and attaining the acquired skillset will translate into better clinical outcomes for patients.

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“…To date, this surgery has been conducted in 5 cases at our department. Because robotic surgery enables microsurgery, its efficacy is expected as a means of surgical treatment of rectal cancer which requires preservation of urinary and sexual function 31) . At present, an RCT designed to compare perioperative complications and the long-term prognosis for rectal cancer associated with robotic surgery and laparoscopic surgery is under way at 20 facilities across the world 32) .…”

Section: Robotic Surgerymentioning

confidence: 99%