Simultaneous robotic-assisted resection of colorectal cancer and synchronous liver metastases: a systematic review

Machairas, Nikolaos; Dorovinis, Panagiotis; Kykalos, Stylianos; Stamopoulos, Paraskevas; Schizas, Dimitrios; Garoufalia, Zoe; Terra, A.; Nikiteas, Nikolaos

doi:10.1007/s11701-021-01213-8

Cited by 22 publications

(23 citation statements)

References 37 publications

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“…Though, some others believe that simultaneous resection can decrease the tumor burden and economic and psychological burden of the subjects, making the subjects experiencing one operation instead of two ( 4 , 34 ). Lately, with the advances in perioperative management and critical care, the operation timing for resectable subjects progressively changed from staged resection to simultaneous resection ( 35 – 37 ). Simultaneous resection of primary colorectal cancer and synchronous colorectal liver metastases is frequently done by open surgery.…”

Section: Discussionmentioning

confidence: 99%

RETRACTED: Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

et al. 2021

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Background: We performed a meta-analysis to evaluate the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases.Methods: A systematic literature search up to April 2021 was done and 13 studies included 1,181 subjects with colorectal cancer and synchronous colorectal liver metastases at the start of the study; 425 of them were using minimally invasive surgery and 756 were open surgery. They were reporting relationships between the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases. We calculated the odds ratio (OR) or the mean difference (MD) with 95% CIs to assess the outcomes of minimally invasive surgery and open surgery in the simultaneous resection of colorectal cancer and synchronous colorectal liver metastases using the dichotomous or continuous method with a random or fixed-effect model.Results: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases was significantly related to longer operation time (MD, 35.61; 95% CI, 7.36–63.87, p = 0.01), less blood loss (MD, −151.62; 95% CI, −228.84 to −74.40, p < 0.001), less blood transfusion needs (OR, 0.61; 95% CI, 0.42–0.89, p = 0.01), shorter length of hospital stay (MD, −3.26; 95% CI, −3.67 to −2.86, p < 0.001), lower overall complications (OR, 0.59; 95% CI, 0.45–0.79, p < 0.001), higher overall survival (OR, 1.66; 95% CI, 1.21–2.29, p = 0.002), and higher disease-free survival (OR, 1.49; 95% CI, 1.13–1.97, p = 0.005) compared to open surgery.Conclusions: Minimally invasive surgery in subjects with colorectal cancer and synchronous colorectal liver metastases may have less blood loss, less blood transfusion needs, shorter length of hospital stay, lower overall complications, higher overall survival, and higher disease-free survival with longer operation time compared with the open surgery. Furthers studies are required to validate these findings.

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Section: Discussionmentioning

confidence: 99%

RETRACTED: Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

et al. 2021

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“…The operation method is more precise, and it can perform delicate surgical operations in the space that cannot be touched by human hands, which overcomes some shortcomings of laparoscopic surgery. In addition, the mechanical arm is similar to and synchronized with the human hand, which is beneficial for doctors to quickly learn operations [ 14 – 16 ].…”

Section: Discussionmentioning

confidence: 99%

Application Effect of Robot-Assisted Laparoscopy in Hepatectomy for Colorectal Cancer Patients with Liver Metastases

Fu²

2022

Computational and Mathematical Methods in Medicine

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Objective. Application effect of Leonardo’s robot-assisted laparoscopy in hepatectomy for colorectal cancer patients with liver metastases. Methods. A total of 122 patients with sCRLM treated in our hospital from May 2015 to June 2018 were selected and divided into observation group ( n = 61 ) and control group ( n = 61 ) according to random number table method. The observation group was treated with robot-assisted laparoscopic hepatectomy, while the control group was treated with conventional laparoscopic hepatectomy. The perioperative time, intraoperative blood transfusion, intraoperative blood loss, average intraoperative blood transfusion, and hepatic portal occlusion time of the two groups were observed. Serum cortisol (Cor), norepinephrine (NE), and glucose (Glu) levels were detected before and after surgery in the two groups. The oxygen consumption and carbon dioxide output of patients were measured 1 day before surgery and 1~3 days after surgery, and the resting energy expenditure (REE) value was calculated. The levels of CD3+, CD4+, and CD8+ were determined by flow cytometry. The incidence of complications was compared between the two groups. Patients were followed up for 3 years after discharge, and Kaplan-Meier method was used to analyze the survival of the two groups. Results. The operation time, intraoperative blood transfusion, intraoperative blood loss, and average intraoperative blood transfusion in the observation group were all less than those in the control group, and the differences were statistically significant ( P < 0.05 ). Three days after operation, the levels of serum Cor, NE, and Glu were increased in both groups, and the observation group was lower than the control group; the difference was statistically significant ( P < 0.05 ). The REE level of observation group was lower than that of control group after 1 day, 2 days, and 3 days after surgery, and the difference was statistically significant ( P < 0.05 ). Three days after operation, the levels of serum CD3+ and CD4+ were decreased in both groups, and the observation group was higher than the control group; the difference was statistically significant ( P < 0.05 ). The incidence of complications in the observation group (3.28%) was lower than that in the control group (13.11%); the difference was statistically significant ( P < 0.05 ).There was no significant difference in survival rate between the two groups after 1, 2, and 3 years of follow-up ( P > 0.05 ). Conclusion. The application of robot-assisted laparoscopy in patients with sCRLM can effectively improve the perioperative situation of patients, reduce stress, energy metabolism, and immune damage, and reduce the incidence of complications.

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“…3,4,7,10,[15][16][17][18][19]14 Despite some recent reviews tried to investigate the role of RLR for CRLMs, so far, indications and limits of RLR for CRLMs has not been clearly investigated. 20,21 To date, there are in the literature cases series and metaanalyses that compare RLR and LLR, but these are often heterogeneous regarding surgical indications and they often included a small sample size of patients. 6,10,16,22 This systematic review aims to assess and clarify the safety and oncological outcomes of the robotic resection of CRCLM through a complete and systematic review of the literature.…”

Section: Introductionmentioning

confidence: 99%

“…Despite some recent reviews tried to investigate the role of RLR for CRLMs, so far, indications and limits of RLR for CRLMs has not been clearly investigated 20,21 …”

Section: Introductionmentioning

confidence: 99%

Robotic surgery for colorectal liver metastases resection: A systematic review

Rocca

Scacchi

Cappuccio

et al. 2021

Robotics Computer Surgery

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Background:The role of robotic surgery for colorectal cancer liver metastases (CRCLMs) has never been investigated in large series.Methods: A systematic literature review was carried out on PubMed and Cochrane libraries. Results:We selected nine studies between 2008 and 2021. Two hundred sixty-two patients were included. One hundred thirty-one patients underwent simultaneous resections. The mean blood loss was 309.4 ml (range, 200-450 ml), the mean operative time was 250.5 min (range, 198.5-449.0 min). The mean length of hospital stay was 7.98 days (range, 4.5 to 12 days). The overall postoperative mortality was 0.4%. The overall morbidity rate was 37.0%, Clavien-Dindo grade III-IV complications were 8.4%. The mean 3-year overall survival was 55.25% (range, 44.4-66.1%), the mean 3-year disease free survival was 37% (range, 33.3-41.9%) Conclusion:We can conclude that robotic-assisted surgery might be considered as a technical upgrade option for minimally invasive approach to CRCLM resections even for simultaneous operations and challenging cases.

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Simultaneous robotic-assisted resection of colorectal cancer and synchronous liver metastases: a systematic review

Cited by 22 publications

References 37 publications

RETRACTED: Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

RETRACTED: Open Resection Compared to Mini-Invasive in Colorectal Cancer and Liver Metastases: A Meta-Analysis

Application Effect of Robot-Assisted Laparoscopy in Hepatectomy for Colorectal Cancer Patients with Liver Metastases

Robotic surgery for colorectal liver metastases resection: A systematic review

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