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.
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.
Authors: Fatima G Wilder; Atuhani Burnett; Joseph Oliver; Michael F Demyen; Ravi J Chokshi Journal: Indian J Surg Date: 2015-10-22 Impact factor: 0.656
Authors: Francesco Feroci; Andrea Vannucchi; Paolo Pietro Bianchi; Stefano Cantafio; Alessia Garzi; Giampaolo Formisano; Marco Scatizzi Journal: World J Gastroenterol Date: 2016-04-07 Impact factor: 5.742
Authors: E Duchalais; N Machairas; S R Kelley; R G Landmann; A Merchea; D T Colibaseanu; K L Mathis; E J Dozois; D W Larson Journal: Surg Endosc Date: 2018-03-15 Impact factor: 4.584
Authors: Rosa M Jiménez Rodríguez; Fernando De la Portilla De Juan; José M Díaz Pavón; Alberto Rodríguez Rodríguez; Emilio Prendes Sillero; Jean Marie Cadet Dussort; Javier Padillo Journal: Int J Colorectal Dis Date: 2014-03-21 Impact factor: 2.571