Robotic surgery versus conventional laparoscopy in colon cancer patients: a systematic review and meta-analysis

Abstract

ABSTRACT Purpose: To compare robotic versus laparoscopic colectomies in colon cancer patients in general complications. Methods: Nine databases were searched for randomized controlled trials (RCT) investigating patients with colon cancer, submitted to robotic surgery (RS) compared to a laparoscopic (LC) approach. The risk of bias was assessed using RoB 2.0 tool, and certainty of the evidence was evaluated by Grading of Recommendations, Assessment, Development and Evaluation (GRADE). Data synthesis was performed using the software R. The meta-analysis of the included studies was carried out using the fixed-effects model (DerSimonian and Laird). Heterogeneity was measured using I2 analysis. Results: A total of four studies were used with 293 patients. Three studies were used in this comparative LC vs. RS when evaluating infection rates on surgical wound sites. The odds ratio (OR) appeared to be slightly favorable to LC (OR = 3.05; 95% confidence interval–95%CI 0.78–11.96). In the hospitalization rates analysis, two randomized controlled trials were used, and the mean differences slightly favored the RS (MD = -0.54; 95%CI -2.28–1.19). GRADE evaluation detected a serious risk of bias due to RCT format and RoB-2 concurred. Conclusion: Both types of procedures seem to have their own benefits, risks, and limitations. They seem close to equal in terms of postsurgical infection and hospitalization.

Keywords

• Colonic Neoplasms
• Robotic Surgical Procedures
• Colectomy