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Surgical Endoscopy

Published in:

01-06-2015

Robotic versus laparoscopic surgery for colonic disease: a meta-analysis of postoperative variables

Authors: Alberto Zarak, Alvaro Castillo, Kandace Kichler, Lucy de la Cruz, Leonardo Tamariz, Srinivas Kaza

Published in: Surgical Endoscopy | Issue 6/2015

Abstract

Introduction

An increasing number of studies have been published since the introduction of robotic technology into general surgery. Gastrointestinal surgery is an area of special interest for the robotic surgeon. Colonic surgery can be challenging depending on the disease and the operative approach. We seek to perform a meta-analysis comparing robotic surgery against laparoscopic surgery in this particular field.

Materials and methods

We performed a systematic search of MEDLINE database from January 2001 to July 2013 supplemented by manual searches of bibliographies of key relevant articles. Randomized controlled trials and cohort studies were selected for review and for collection of postoperative data (length of stay, time to first flatus and complications).

Results

After careful review, nine studies were considered for analysis. Non-pooled data showed a slight trend toward laparoscopy with increased number of events without statistical significance. Pooled data demonstrated a statistical significance for return to bowel function in the right and mixed robotic colectomy arm (WSMD −0.33, 95 % CI −0.5, −0.1; p < 0.005 and WSMD −0.26, 95 % CI −0.51, 0.0; p = 0.05). Pooled data of length of stay and complications showed no statistical significance between robotic and laparoscopic colonic surgery.

Discussion

Robotic surgery is a comparable option when dealing with colonic disease, either benign or malignant. No difference in complication rate or length of stay was found when comparing the two. Robotic surgery appears to have an advantage over laparoscopy in regards to return of bowel function when dealing with right colectomies.

Makin GB, Breen DJ, Monson JR (2001) The impact of new technology on surgery for colorectal cancer. World J Gastroenterol 7(5):612–621PubMed

Kim CW, Kim CH, Baik SH (2014) Outcomes of robotic-assisted colorectal surgery compared with laparoscopic and open surgery: a systematic review. J Gastrointest Surg 18(4):816–830CrossRefPubMed

Xiong B, Ma L, Zhang C, Cheng Y (2014) Robotic versus laparoscopic total mesorectal excision for rectal cancer: a meta-analysis. J Surg Res 188:404–414CrossRefPubMed

González Fernández AM, Mascareñas González JF (2012) Total laparoscopic mesorectal excision versus robot-assisted in the treatment of rectal cancer: a meta-analysis. Cir Esp 90(6):348–354CrossRefPubMed

Memon S, Heriot AG, Murphy DG et al (2012) Robotic versus laparoscopic proctectomy for rectal cancer: a meta-analysis. Ann Surg Oncol 19(7):2095–2101CrossRefPubMed

Rockall TA, Darzi A (2003) Robot-assisted laparoscopic colorectal surgery. Surg Clin North Am 83(6):1463–1468CrossRefPubMed

Hance J, Rockall T, Darzi A (2004) Robotics in colorectal surgery. Dig Surg 21(5–6):339–343CrossRefPubMed

Pigazzi A, Ellenhorn JD, Ballantyne GH et al (2006) Robotic-assisted laparoscopic low anterior resection with total mesorectal excision for rectal cancer. Surg Endosc 20(10):1521–1525CrossRefPubMed

Oxman AD, Guyatt GH (1991) Validation of an index of the quality of review articles. J Clin Epidemiol 44:1271–1278CrossRefPubMed

10.

Woeste G, Bechstein WO, Wullstein C (2005) Does telerobotic assistance improve laparoscopic colorectal surgery? Int J Colorectal Dis 20(3):253–257CrossRefPubMed

11.

Rawlings AL, Woodland JH, Vegunta RK et al (2007) Roboticversus laparoscopic colectomy. Surg Endosc 21(10):1701–1708 Epub 2007 Mar 13CrossRefPubMed

12.

deSouza AL, Prasad LM, Park JJ et al (2010) Robotic assistance in right hemicolectomy: is there a role? Dis Colon Rectum 53(7):1000–1006CrossRefPubMed

13.

Deutsch GB, Sathyanarayana SA, Gunabushanam V et al (2012) Robotic vs. laparoscopic colorectal surgery: an institutional experience. Surg Endosc 26(4):956–963CrossRefPubMed

14.

Bertani E, Chiappa A, Biffi R et al (2011) Assessing appropriateness for elective colorectal cancer surgery: clinical, oncological, and quality-of-lifeshort-term outcomes employing different treatment approaches. Int J Colorectal Dis 26(10):1317–1327CrossRefPubMed

15.

Shin JY (2012) Comparison of short-term surgical outcomes between a robotic colectomy and a laparoscopic colectomy during early experience. J Korean Soc Coloproctol 28(1):19–26CrossRefPubMedCentralPubMed

16.

Park JS, Choi GS, Park SY et al (2012) Randomized clinical trial of robot-assisted versus standard laparoscopic right colectomy. Br J Surg 99(9):1219–1226CrossRefPubMed

17.

Lim DR, Min BS, Kim MS et al (2013) Robotic versus laparoscopic anterio resection of sigmoid colon cancer: comparative study of long-termoncologic outcomes. Surg Endosc 27(4):1379–1385CrossRefPubMedCentralPubMed

18.

Helvind NM, Eriksen JR, Mogensen A et al (2013) No differences in short-term morbidity and mortality after robot-assisted laparoscopic versus laparoscopic resection for colonic cancer: a case-control study of 263 patients. Surg Endosc 27(7):2575–2580CrossRefPubMed

19.

Dindo D, Demartines N, Clavien PA (2004) Classification of surgical complications: a new proposal with evaluation in a cohort of 6336 patients and results of a survey. Ann Surg 240:205–213CrossRefPubMedCentralPubMed

20.

Luca F, Cenciarelli S, Valvo M et al (2009) Full robotic left colon and rectal cancer resection: technique and early outcome. Ann Surg Oncol 16:1274–1278CrossRefPubMed

21.

Baik SH, Kwon HY, Kim JS et al (2009) Robotic versus laparoscopic low anterior resection of rectal cancer: short-term outcome of a prospective comparative study. Ann Surg Oncol 16:1480–1487CrossRefPubMed

22.

Hellan M, Anderson C, Ellenhorn JD et al (2007) Short term outcomes after robotic-assisted total mesorectal excision for rectal cancer. Ann Surg Oncol 14:3168–3173CrossRefPubMed

23.

Baik SH, Ko YT, Kang CM et al (2008) Robotic tumor-specific mesorectal excision of rectal cancer: short-term outcome of a pilot randomized trial. Surg Endosc 22:1601–1608CrossRefPubMed

24.

Schwab KE, Dowson HM, Van Dellen J et al (2009) The uptake of laparoscopic colorectal surgery in great Britain and Ireland: a questionnaire survey of consultant members of the ACPGBI. Colorectal Dis 11:318CrossRefPubMed

25.

Basse L, Jakobsen DH, Bardram L et al (2005) Functional recovery after open versus laparoscopic colonic resection: a randomized, blinded study. Ann Surg 241:416–423CrossRefPubMedCentralPubMed

26.

Reissman P, Cohen S, Weiss EG et al (1996) Laparoscopic colorectal surgery: ascending the learning curve. World J Surg 20:277–281CrossRefPubMed

27.

Schlachta CM, Mamazza J, Seshadri PA et al (2001) defining a learning curve for laparoscopic colorectal resections. Dis Colon Rectum 44:217–222CrossRefPubMed

28.

Tekkis PP, Senagore AJ, Delaney CP et al (2005) Evaluation of the learning curve in laparoscopic colorectal surgery: comparison of right-sided and left-sided resections. Ann Surg 242:83–91CrossRefPubMedCentralPubMed

29.

Spinoglio G, Summa M, Priora F et al (2008) Robotic colorectal surgery: first 50 cases experience. Dis Colon Rectum 51:1627–1632CrossRefPubMed

30.

Bokhari MB, Patel CB, Ramos-Valadez DI et al (2011) Learning curve for robotic-assisted laparoscopic colorectal surgery. Surg Endosc 25:855–860CrossRefPubMedCentralPubMed

31.

Maeso S, Reza M, Mayol JA et al (2010) Efficacy of the Da Vinci surgical system in abdominal surgery compared with that of laparoscopy: a systematic review and meta-analysis. Ann Surg 252(2):254–262CrossRefPubMed

Title: Robotic versus laparoscopic surgery for colonic disease: a meta-analysis of postoperative variables
Authors: Alberto Zarak
Alvaro Castillo
Kandace Kichler
Lucy de la Cruz
Leonardo Tamariz
Srinivas Kaza
Publication date: 01-06-2015
Publisher: Springer US
Published in: Surgical Endoscopy / Issue 6/2015
Print ISSN: 0930-2794
Electronic ISSN: 1432-2218
DOI: https://doi.org/10.1007/s00464-015-4197-7

At a glance: The STEP trials

Springer Medicine

Robotic versus laparoscopic surgery for colonic disease: a meta-analysis of postoperative variables

Abstract

Introduction

Materials and methods

Results

Discussion

At a glance: The STEP trials

Springer Medicine

Abstract

Introduction

Materials and methods

Results

Discussion

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