A systematic review and meta-analysis of laparoscopic versus robotic rectal surgery with primary anastomosis

• Authors: Mateusz Rubinkiewicz , Jan Witowski , Karolina Zbroja , Kamil Rozmus , Julia Krzywoń , Katarzyna Truszkiewicz

Abstracts

EN

Purpose: Rectal cancer is one of the most common malignancies of the gastrointestinal tract. The gold standard method is surgical resection. The approach to rectal cancer is still controversial. Nowadays, robotic approach gains popularity in comparison to traditional laparoscopy. However, there is lack of studies assessing rectal resections with primary anastomosis. Methods: We performed a systematic review and meta-analysis according to the PRISMA guidelines. The primary outcomes of interest were morbidity and short-term complications. Results: An initial reference search yielded 1250 articles. Finally, we chose six studies covering 1580 patients that we included in the quantitative analysis. In our study, we demonstrated that laparoscopic and robotic surgery are non-inferior to one another in terms of morbidity (RR=1.1 95% CI: 0.89-1.39), major complication rate (RR=1.01, 95% CI: 0.60-1.69) or in length of hospitalization (MD=0,15 95% CI: -0.60−0.90). The latter has slight advantage in quality of mesorectal excision (RD = -0.19, 95% CI: -0.35 − -0.03. I2=69%) and anastomotic leakage rate (OR=2.25, 95% CI: 1.23-4.09, I2=0%). Conclusion: In certain cases Robotic Surgery provide better quality of resected specimen and lower leakage ratio, nevertheless due to heterogeneity the results are uncertain. There is substantial need for large randomized controlled studies.

Keywords

EN

laparoscopic; meta-analysis; rectal cancer; robotic; systematic review

• Publisher: Index Copernicus International
• Journal: Polish Journal of Surgery
• Year: 2020
• Volume: 92(1)
• Pages: 5-11

Dates

published

2019-11-05

Contributors

author

Mateusz Rubinkiewicz

author

Jan Witowski

author

Karolina Zbroja

author

Kamil Rozmus

author

Julia Krzywoń

author

Katarzyna Truszkiewicz

Identifiers

DOI

10.5604/01.3001.0013.5549