Comparison of robotic right colectomy and laparoscopic right colectomy: a systematic review and meta-analysis

Background For right colon surgery, there is an increasing body of literature comparing the safety of robotic right colectomy (RRC) with laparoscopic right colectomy (LRC). The aim of the present systematic review and meta-analysis is to assess the safety and efficacy of RRC versus LRC, including ho...

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Bibliographic Details
Published in:Techniques in coloproctology 2023-07, Vol.27 (7), p.521-535
Main Authors: Zheng, Jianchun, Zhao, Shuai, Chen, Wei, Zhang, Ming, Wu, Jianxiang
Format: Article
Language:English
Subjects:
Abdominal Surgery
Anastomosis, Surgical - adverse effects
Colectomy - adverse effects
Colonic Neoplasms - surgery
Colorectal Surgery
Flatulence - surgery
Gastroenterology
Humans
Laparoscopy
Laparoscopy - adverse effects
Laparotomy
Length of Stay
Lymphatic system
Medicine
Medicine & Public Health
Meta-analysis
Operative Time
Proctology
Retrospective Studies
Review
Robotic Surgical Procedures - adverse effects
Surgery
Systematic review
Treatment Outcome
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Summary:Background For right colon surgery, there is an increasing body of literature comparing the safety of robotic right colectomy (RRC) with laparoscopic right colectomy (LRC). The aim of the present systematic review and meta-analysis is to assess the safety and efficacy of RRC versus LRC, including homogeneous subgroup analyses for extracorporeal anastomosis (EA) and intracorporeal anastomosis (IA). Methods PubMed, Web of Science, Embase, and Cochrane Library databases were searched for studies published between January 2000 and January 2022. Length of hospital stay, operation time, rate of conversion to laparotomy, time to first flatus, number of harvested lymph nodes, estimated blood loss, rate of overall complication, ileus, anastomotic leakage, wound infection, and total costs were measured. Results Forty-two studies (RRC: 2772 patients; LRC: 12,469 patients) were evaluated. Regardless of the type of anastomosis, RRC showed shorter length of hospital stay, lower rate of conversion to laparotomy, shorter time to first flatus, lower rate of overall complications, and a higher number of harvested lymph nodes compared with LRC, but longer operative time and higher total costs. In the IA subgroup, RRC had a shorter length of hospital stay, longer operative time, and lower rate of conversion to laparotomy compared with LRC, with no difference for the remaining outcomes. In the EA subgroup, RRC had a longer operative time, lower estimated blood loss, lower rate of overall complications, and higher total costs compared with LRC, with the other outcomes being similar. Conclusion The safety and efficacy of RRC is superior to LRC, especially when an intracorporeal anastomosis is performed. Most included articles were retrospective, offering low-quality evidence and limited conclusions.
ISSN:1123-6337
1128-045X
DOI:10.1007/s10151-023-02821-2