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Robot-Assisted Versus Conventional Laparoscopic Surgery for Colorectal Disease, Focusing on Rectal Cancer: A Meta-analysis

  • Colorectal Cancer
  • Published:
Annals of Surgical Oncology Aims and scope Submit manuscript

Abstract

Background

Robotic colorectal surgery may solve some of the problems inherent to conventional laparoscopic surgery (CLS). We sought to evaluate the advantages of robot-assisted laparoscopic surgery (RALS) using the da Vinci Surgical System over CLS in patients with benign and malignant colorectal diseases.

Methods

PubMed and Embase databases were searched for relevant studies published before July 2011. Studies clearly documenting a comparison of RALS with CLS for benign and malignant colorectal diseases were selected. Operative and postoperative measures, resection margins, complications, and related outcomes were evaluated. Weighted mean differences, relative risks, and hazard ratios were calculated using a random-effects model.

Results

The meta-analysis included 16 studies comparing RALS and CLS in patients with colorectal diseases and 7 studies in rectal cancer. RALS was associated with lower estimated blood loss in colorectal diseases (P = 0.04) and rectal cancer (P < 0.001) and lower rates of intraoperative conversion in colorectal diseases (P = 0.03) and rectal cancer (P < 0.001) than CLS. In patients with colorectal diseases, however, operating time (P < 0.001) and total hospitalization cost (P = 0.06) were higher for RALS than for CLS.

Conclusions

RALS was associated with reduced estimated blood loss and a lower intraoperative conversion rate than CLS, with no differences in complication rates and surrogate markers of successful surgery. Robotic colorectal surgery is a promising tool, especially for patients with rectal cancer.

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Acknowledgment

Financially sponsored by the Shanghai Rising-Star Program (No. 11QA1404800), grants from the National Natural Science Foundation of China (Grant 81001069), and the National 863 High Technology Foundation (Grant 2009AA02Z118).

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Authors and Affiliations

  1. Department of Surgery, Shanghai Tenth People’s Hospital Affiliated to Tongji University, Shanghai, People’s Republic of China

    Yongzhi Yang MS, Feng Wang PhD, Peng Zhang PhD, Huanlong Qin MD & Yanlei Ma PhD

  2. Department of Surgery, The Sixth People’s Hospital Affiliated to Shanghai Jiao Tong University, Shanghai, People’s Republic of China

    Yongzhi Yang MS, Chenzhang Shi PhD & Yang Zou MS

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  1. Yongzhi Yang MS
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  2. Feng Wang PhD
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  6. Huanlong Qin MD
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  7. Yanlei Ma PhD
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Correspondence to Yanlei Ma PhD.

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Yang, Y., Wang, F., Zhang, P. et al. Robot-Assisted Versus Conventional Laparoscopic Surgery for Colorectal Disease, Focusing on Rectal Cancer: A Meta-analysis. Ann Surg Oncol 19, 3727–3736 (2012). https://doi.org/10.1245/s10434-012-2429-9

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  • DOI: https://doi.org/10.1245/s10434-012-2429-9

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