JOURNAL OF SHANDONG UNIVERSITY (HEALTH SCIENCES) ›› 2014, Vol. 52 ›› Issue (7): 60-65.doi: 10.6040/j.issn.1671-7554.0.2013.700

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Robotic versus laparoscopic low anterior resection：a meta-analysis

XU Huirong1,2, LI Jianning3, LI Zengjun1, XU Zhongfa1   

  1. 1. Department of Gastrointestinal Surgery, Shandong Cancer Hospital, Jinan 250117, Shandong, China;
    2. Medicine and Life Science College, Jinan University, Shandong Academy of Medical Sciences, Jinan 250200, Shandong, China;
    3. Department of Anesthesiology, Affiliated Hospital of Shandong Academy of Medical Sciences, Jinan 250031, Shandong, China
  • Received:2013-11-22 Revised:2014-06-12 Online:2014-07-10 Published:2014-07-10

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Abstract: Objective To compare the short-term efficacy of robotic low anterior resection (R-LAR) versus laparoscopic low anterior resection (L-LAR) for rectal cancer with meta-analysis. Methods Databases including Medline, Embase, Ovid, CNKI and WANFANG were searched for studies that compared clinical or oncologic outcomes of R-LAP and L-LAP. Relevant published and unpublished data and references were also retrieved. The methodological quality of the incorporated researches was evaluated by two reviewers independently, and RevMan 5.2 software was used for meta-analysis. Results Six studies with 375 patients were included in the analysis. The results showed that R-LAP had longer hospital stay[MD=-1.09, 95%CI(-1.95 to -0.22), P=0.01], lower conversion rate[OR=0.09, 95%CI(0.02 to 0.47), P=0.005], lower circumferential margin involvement positive rate[OR=0.3, 95%CI(0.11 to 0.83), P=0.02], lower overall complication rate[OR=0.55, 95%CI (0.32 to 0.95), P=0.03] compared with L-LAP. There was no difference in operation time[MD=34.25, 95%CI(-5.09 to 73.58), P=0.09] and the number of cleared lymph nodes[MD=1, 95%CI(-0.67 to 2.67), P=0.24]. Conclusion Compared with L-LAR, R-LAR produces more favorable postoperative and oncologic outcomes.

Key words: Da Vinci surgical system, Laparoscopic surgery, Meta-analysis, Rectal cancer, Low anterior resection

CLC Number: 

  • R61
[1] Jacobs M, Verdeja J C, Goldstein H S. Minimally invasive colon resection (laparoscopic colectomy)[J]. Surg Laparosc Endosc, 1991, 1(3):144-150.
[2] Veldkamp R, Kuhry E, Hop W C, et al. Laparoscopic surgery versus open surgery for colon cancer: short-term outcomes of a randomised trial[J]. Lancet Oncol, 2005, 6(7):477-484.
[3] Karahasanoglu T, Hamzaoglu I, Baca B, et al. Impact of increased body mass index on laparoscopic surgery for rectal cancer[J]. Eur Surg Res, 2011, 46(2):87-93.
[4] Hübner M, Diana M, Zanetti G, et al. Surgical site infections in colon surgery: the patient, the procedure, the hospital, and the surgeon[J]. Arch Surg, 2011, 146(11):1240-1245.
[5] Lanfranco A R, Castellanos A E, Desai J P, et al. Robotic surgery: a current perspective[J]. Ann Surg, 2004, 239(1):14-21.
[6] Higgins J P T, Green S. Cochrane handbook for systematic reviews of interventions. Version 5.1.0 [updated March 2011][EB/OL]. [2013-10-02]. http://hand book.cochrane.org/.
[7] 刘建平. 非随机研究的系统评价方法(一)[J]. 中国循证医学,2001,1(4):239-243.
[8] Pigazzi A, Ellenhorn J D I, Ballantyne G H, et al. Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer[J]. Surg Endosc, 2006, 20(10):1521-1525.
[9] Baik S H, Ko Y T, Kang C M, et al. Robotic tumor-specific mesorectal excison of rectal cancer: short-term outcome of a pilot randomized trial[J]. Surg Endosc, 2008, 22(7):1601-1608.
[10] Baik S H, Kwon H Y, Kim J S, et al. Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study[J]. Ann Surg Oncol, 2009, 16(6):1480-1487.
[11] Erguner I, Aytac E, Boler D E, et al. What have we gained by performing robotic rectal resection? Evaluation of 64 consecutive patients who underwent laparoscopic or robotic low anterior resection for rectal adenocarcinoma[J]. Surg Laparosc Endosc Percutan Tech, 2013, 23(3):316-319.
[12] D'Annibale A, Pernazza G, Monsellato I, et al. Total mesorectal excision: a comparison of oncological and functional outcomes between robotic and laparoscopic surgery for rectal cancer[J]. Surg Endosc, 2013, 27(6):1887-1895.
[13] Marecik S, Zawadzki M,Velchuru V R, et al. Cost comparison of Robot-assisted versus hand assisted laparoscopic anterior resections for rectal cancer[J]. Colorectal Dis, 2011, 6 (24):16-27.
[14] Weber P A. Telerobotic-assisted laparoscopic right and sigmoid colectomies for benign disease[J]. Dis Colon Rectum, 2002, 45(12):1689-1696.
[15] Baek S K, Carmichael J C, Pigazzi A. Robotic surgery: colon and rectum[J]. Cancer J, 2013, 19(2):140-146.
[16] Trastulli S, Farinella E, Cirocchi R, et al. Robotic resection compared with laparoscopic rectal resection for cancer: systematic review and meta-analysis of short-term outcome[J]. Colorectal Dis, 2012, 14(4):e134-e156.
[17] Memon S, Heriot A G, Murphy D G, et al. Robotic versus laparoscopic proctectomy for rectal cancer: a meta-analysis[J]. Ann Surg Oncol, 2012, 19(7):2095-2101.
[18] Hong Y, Baik Y, Hur H, et al. Comparison of short-term outcomes after hybrid vs totally robotic total mesorectal excision[J]. Dis Colon Rectum, 2010, 53:698.
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