Postoperative complications observed with robotic versus laparoscopic surgery for the treatment of rectal cancer

Abstract

Background: This is an updated meta-analysis comparing the postoperative complications observed with robotic versus laparoscopic surgery (LS) for the treatment of rectal cancer. Methods: Cochrane central, MEDLNE (Medical Literature Analysis and Retrieval System Online), EMBASE (Excerpta Medica dataBASE), Google Scholar, Web of Science and http://www.ClinicalTrials.gov were searched for studies (published after the year 2015), comparing robotic versus LS for the treatment of rectal cancer. The postoperative outcomes were considered as the endpoints in this analysis. RevMan 5.4 was used to carry out the statistical analysis. Risk ratio (RR) with 95% confidence intervals (CI) were used to represent the results following data analysis. Results A total number of 22,744 participants were included in this study whereby 9178 participants were assigned to the robotic surgery and 13,566 participants were assigned to the LS group. The time period of patients’ enrollment varied from years 2007 to 2017. Our results showed that overall complications (RR: 0.91, 95% CI: 0.71–1.17; P = .45), wound complications (RR: 0.81, 95% CI: 0.64–1.04; P = .09), anastomotic leak (RR: 1.12, 95% CI: 0.88–1.42; P = .37), anastomotic bleeding (RR: 0.88, 95% CI: 0.29–2.64; P = .82), stoma-related complications (RR: 0.88, 95% CI: 0.24–3.21; P = .85), intra-abdominal abscess (RR: 0.53. 95% CI: 0.22–1.31; P = .17), urinary tract infection (RR: 0.94, 95% CI: 0.53–1.66; P = .83), enterocolitis (RR: 1.35, 95% CI: 0.38–4.71; P = .64), reoperation (RR: 0.85, 95% CI: 0.46–1.54; P = .58), and mortality (RR: 0.75, 95% CI: 0.34–1.62; P = .46) were not significantly different between robotic-assisted versus LS for rectal cancer. Postoperative ileus (RR: 1.21, 95% CI: 0.81–1.81; P = .34), readmission (RR: 1.17, 95% CI: 0.75–1.83; P = .48), and urinary retention (RR: 0.51, 95% CI: 0.21–1.23; P = .14) were also similarly manifested. Conclusions: In this updated meta-analysis, both robotic and laparoscopic surgeries were equally effective for the treatment of rectal cancer. Similar postoperative complications were observed. However, our analysis was restricted only to postoperative outcomes, parameters such as duration of surgery were not taken into consideration.

Nomogram for prediction of prolonged postoperative ileus after colorectal resection

“…The robotic surgical systems for the treatment of colorectal cancer were introduced into this hospital in 2020, but only a minority of patients have been treated with robotic surgery because of its high cost. Previous studies have shown that there are no significant differences between laparoscopic and robotic approaches to PPOI and perioperative mortality [ 32 , 33 ]. Therefore, we combined laparoscopic and robotic surgery into one group in this study.…”

A meta‐analysis of postoperative wound complications at the surgical site in prostate cancer patients undergoing robotic surgery

“…In a broader surgical context, meta‐analyses in gastric cancer surgeries comparing robotic and open approaches have found no significant difference in the rate of wound infections between the two methods. Similarly, research in rectal cancer surgeries comparing robotic and laparoscopic approaches has shown no significant differences in overall complications, including wound complications 5 . These findings are crucial as they offer a broader perspective on the efficacy of robotic surgery across different types of cancer surgeries.…”

“…Similarly, research in rectal cancer surgeries comparing robotic and laparoscopic approaches has shown no significant differences in overall complications, including wound complications. 5 These findings are crucial as they offer a broader perspective on the efficacy of robotic surgery across different types of cancer surgeries.…”

Robotic surgery in patients with colorectal cancer: Techniques and benefits - Integrative review

“…The Evolution of Research in Health Science Robotic surgery in patients with colorectal cancer: Techniques and benefits -Integrative review nervous structures. 12,13 In addition, robotic surgery eliminates physiological tremors, offers greater ergonomic comfort and reduces surgeon fatigue 13,14,15,16,17,18,19,20 .The robotic system also demonstrates ambidextrous ability during the surgical procedure, providing greater precision and allowing the execution of fine and precise movements, thanks to its advanced computer interface.In addition, there is preservation of the patient's voiding and sexual function, as this technique protects the superior and inferior hypogastric nerve plexus, as well as the pelvic nerve. 21,15 Similarly, in their randomized clinical trial, Chang et al 22 compared robotic surgery with open surgery for the simultaneous resection of rectal cancer and liver metastases, in which it was noted that 76 patients (44.4%) had surgical complications: 27 (31.4%) in the robotic group and 49 (57.6%) in the open group.…”