Robotic assistance may reduce conversion to open in rectal carcinoma laparoscopic surgery: systematic review and meta-analysis

Authors

  • Elena Ortiz-Oshiro,

    Corresponding author
    • General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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  • Iris Sánchez-Egido,

    1. General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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  • Jesús Moreno-Sierra,

    1. General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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  • Cristina Fernández Pérez,

    1. General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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  • Jesús Sánchez Díaz,

    1. General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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  • Jesús Álvarez Fernández-Represa

    1. General and Digestive Surgery Department, Methodology and Clinical Epidemiology Unit, Preventive Medicine Department, Hospital Clinico San Carlos, Universidad Complutense, Madrid, Spain
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E. Ortiz-Oshiro, Department of Surgery, Hospital Clínico San Carlos, c/o Professor Martin Lagos, s/n 28040 Madrid, Spain. E-mail: elenaortiz@seclaendosurgery.com, eortosh@gmail.com

Abstract

Background

We hypothesized that robotic assistance (RARS) could provide better intraoperative and short-term outcomes than a traditional laparoscopic approach (LARS) to rectal cancer surgery.

Methods

Systematic review of the literature, including electronic searches and communications to international robotic meetings. Inclusion criteria: studies involving rectal cancer patients and comparing outcomes of robotic surgery vs laparoscopic surgery. Primary end-points: conversion and postoperative short-term complications. Meta-analysis performed using Review Manager 5.0 software.

Results

Five case–control studies involving 486 patients (203 RARS–283 LARS) were finally included. Conversion to open rate (RR = 0.31; 95% CI 0.12,0.78) was lower for RARS. No differences were found in oncological outcomes, hospital stay or anastomotic leakage.

Conclusions

This meta-analysis of available non-randomized studies suggests that conversion to open rate may be reduced when using RARS instead of LARS for rectal cancer. Copyright © 2012 John Wiley & Sons, Ltd.

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