Brief Article
Copyright ©2011 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Gastroenterol. Dec 21, 2011; 17(47): 5214-5220
Published online Dec 21, 2011. doi: 10.3748/wjg.v17.i47.5214
Meta-analysis of robotic and laparoscopic surgery for treatment of rectal cancer
Shuang Lin, Hong-Gang Jiang, Zhi-Heng Chen, Shu-Yang Zhou, Xiao-Sun Liu, Ji-Ren Yu
Shuang Lin, Hong-Gang Jiang, Zhi-Heng Chen, Department of Oncological Surgery, First Affiliated Hospital of Jiaxing University, Jiaxing 314000, Zhejiang Province, China
Shu-Yang Zhou, Xiao-Sun Liu, Ji-Ren Yu, Department of Gastroenterological Surgery, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China
Author contributions: Lin S wrote the paper and performed the research; Yu JR and Jiang HG designed the research; Liu XS and Chen ZH collected the data; Chen ZH and Zhou SY performed a literature search and retrieved the data; Yu JR was consulted and analyzed the data.
Supported by The National Natural Science Foundation of China, No. 81071964; Zhejiang Provincial Natural Science Foundation of China, No. Y2110019
Correspondence to: Ji-Ren Yu, MD, Department of Gastroenterological Surgery, First Affiliated Hospital, Medical College, Zhejiang University, Hangzhou 310003, Zhejiang Province, China. yujiren0909@hotmail.com
Telephone: +86-571-87236147 Fax: +86-571-87072577
Received: August 11, 2011
Revised: October 2, 2011
Accepted: November 9, 2011
Published online: December 21, 2011
Abstract

AIM: To conduct a meta-analysis to determine the relative merits of robotic surgery (RS) and laparoscopic surgery (LS) for rectal cancer.

METHODS: A literature search was performed to identify comparative studies reporting perioperative outcomes for RS and LS for rectal cancer. Pooled odds ratios and weighted mean differences (WMDs) with 95% confidence intervals (95% CIs) were calculated using either the fixed effects model or random effects model.

RESULTS: Eight studies matched the selection criteria and reported on 661 subjects, of whom 268 underwent RS and 393 underwent LS for rectal cancer. Compared the perioperative outcomes of RS with LS, reports of RS indicated favorable outcomes considering conversion (WMD: 0.25; 95% CI: 0.11-0.58; P = 0.001). Meanwhile, operative time (WMD: 27.92, 95% CI: -13.43 to 69.27; P = 0.19); blood loss (WMD: -32.35, 95% CI: -86.19 to 21.50; P = 0.24); days to passing flatus (WMD: -0.18, 95% CI: -0.96 to 0.60; P = 0.65); length of stay (WMD: -0.04; 95% CI: -2.28 to 2.20; P = 0.97); complications (WMD: 1.05; 95% CI: 0.71-1.55; P = 0.82) and pathological details, including lymph nodes harvested (WMD: 0.41, 95% CI: -0.67 to 1.50; P = 0.46), distal resection margin (WMD: -0.35, 95% CI: -1.27 to 0.58; P = 0.46), and positive circumferential resection margin (WMD: 0.54, 95% CI: 0.12-2.39; P = 0.42) were similar between RS and LS.

CONCLUSION: RS for rectal cancer is superior to LS in terms of conversion. RS may be an alternative treatment for rectal cancer. Further studies are required.

Keywords: Robotic surgery; Laparoscopic surgery; Rectal cancer; Da Vinci robotic system; Meta-analysis