Log in | Register
Sameer Memon FRACS, Alexander G. Heriot MD, MBA, FRACS, FRCS, Declan G. Murphy FRCS Urol, Mathias Bressel MSc, A. Craig Lynch MMedSci, FRACS, FCSSANZ, FASCRS (Int) Healthcare Policy and Outcomes Volume 19, Issue 7 / July , 2012
View full article HTML | View full article PDF | Download Citation
Robot-assisted laparoscopic surgery is being performed more frequently for the minimally invasive management of rectal cancer. The objective of this meta-analysis was to compare the clinical and oncologic safety and efficacy of robot-assisted versus conventional laparoscopic surgery.
A search of the Medline and Embase databases was performed for studies that compared clinical or oncologic outcomes of conventional laparoscopic proctectomy with robot-assisted laparoscopic proctectomy for rectal cancer. The methodological quality of the selected studies was critically assessed to identify studies suitable for inclusion. Meta-analysis was performed by a random effects model and analyzed by Review Manager. Clinical outcomes evaluated were conversion rates, operation times, length of hospital stay, and complications. Oncologic outcomes evaluated were circumferential margin status, number of lymph nodes collected, and distal resection margin lengths.
Eight comparative studies were assessed for quality, and seven studies were included in the meta-analysis. Two studies were matched case-control studies, and five were unmatched. A total of 353 robot-assisted laparoscopic surgery proctectomy cases and 401 conventional laparoscopic surgery proctectomy cases were analyzed. Robotic surgery was associated with a significantly lower conversion rate (P = 0.03; 95% confidence interval 1–12). There was no difference in complications, circumferential margin involvement, distal resection margin, lymph node yield, or hospital stay (P = NS).
Robot-assisted surgery decreased the conversion rate compared to conventional laparoscopic surgery. Other clinical outcomes and oncologic outcomes were equivalent. The benefits of robotic rectal cancer surgery may differ between population groups.
Go to Issue Contents
Add this article to your Personal Archive
Effective January 2013, there will be a processing fee of $50 USD for each initial new submission of an Annals article, excluding editorials. Submitted new manuscripts will not enter the review process until the submission fee has been paid. . There will be no processing fee associated with resubmitted manuscripts.
HIGHLIGHTED VIDEO OF THE MONTH
Lymphatic Mapping and Sentinel Node Biopsy in the Colonic Mesentery by Natural Orifice Transluminal Endoscopic Surgery (NOTES) by R. A. Cahill MD, FRCS, S. Perretta MD, J. Leroy MD, B. Dallemagne MD, and J. Marescaux MD, FRCS, FACS. Annals of Surgical Oncology. Volume 15, Number 10, DOI: 10.1245/s10434-008-9952-8