Comparison of pathologic outcomes of robotic and open resections for rectal cancer: A systematic review and meta-analysis

PLoS One. 2021 Jan 13;16(1):e0245154. doi: 10.1371/journal.pone.0245154. eCollection 2021.

Abstract

Objective: The application of robotic surgery for rectal cancer is increasing steadily. The purpose of this meta-analysis is to compare pathologic outcomes among patients with rectal cancer who underwent open rectal surgery (ORS) versus robotic rectal surgery (RRS).

Methods: We systematically searched the literature of EMBASE, PubMed, the Cochrane Library of randomized controlled trials (RCTs) and nonrandomized controlled trials (nRCTs) comparing ORS with RRS.

Results: Fourteen nRCTs, including 2711 patients met the predetermined inclusion criteria and were included in the meta-analysis. Circumferential resection margin (CRM) positivity (OR: 0.58, 95% CI, 0.29 to 1.16, P = 0.13), number of harvested lymph nodes (WMD: -0.31, 95% CI, -2.16 to 1.53, P = 0.74), complete total mesorectal excision (TME) rates (OR: 0.93, 95% CI, 0.48 to 1.78, P = 0.83) and the length of distal resection margins (DRM) (WMD: -0.01, 95% CI, -0.26 to 0.25, P = 0.96) did not differ significantly between the RRS and ORS groups.

Conclusion: Based on the current evidence, robotic resection for rectal cancer provided equivalent pathological outcomes to ORS in terms of CRM positivity, number of harvested lymph nodes and complete TME rates and DRM.

Publication types

  • Comparative Study
  • Meta-Analysis
  • Research Support, Non-U.S. Gov't
  • Systematic Review

MeSH terms

  • Humans
  • Prognosis
  • Rectal Neoplasms / diagnosis
  • Rectal Neoplasms / surgery*
  • Robotic Surgical Procedures*

Grants and funding

This work was supported by the National Basic Research Program of China (973 Program) to JW (No. 2015CB554001), the National Natural Science Foundation of China to YL (No. 81472257) and XW (No. 81502022), the Natural Science Fund for Distinguished Young Scholars of Guangdong Province to YL (No. 2016A030306002), the Fundamental Research Funds for the Central Universities to LL (lzujbky-2019-kb21) and YL (lzujbky-2020-kb22), and the Institute Scientific Research Fund Project/Youth Project to LL (No. 20GSSY4-8).