Robotic surgery versus laparoscopic surgery in colorectal cancer patients - a systematic review

Abstract

Objectives: Robotic-assisted surgery was first used in the context of colorectal cancer in 2002, aiming to overcome the technical difficulties presented by a traditional laparoscopic approach. The target of this systematic review was to evaluate the security of robotic surgery in comparison to laparoscopic surgery for colorectal cancer patients. Methods: In accordance with the PRISMA statement, a research was made in four databases (MEDLINE, Web of Science, Embase and Cochrane's CENTRAL) to identify randomised controlled trials and retrospective or prospective observational studies up to November 12, 2021, which compare the post-operative complications of colorectal cancer patients submitted to robotic surgery versus laparoscopic surgery. The quality assessment was made using the Cochrane's RoB2 tool, for the randomized controlled trials, and the National Institutes of Health criteria, for the non-randomized studies. Results: 24 studies were included in the review. In general, the populations were well-matched. There were globally no statistical differences between the surgical methods in the pathological and clinical outcomes, including short-term mortality, which had very low rates in both types of surgery. Robotic surgery led to fewer conversions to open surgery, a smaller duration of hospital stay, and had a longer time of operation and was more expensive than laparoscopic surgery. Discussion/Conclusion: Robotic surgery is a safe approach to colorectal cancer resection, yet it is not cost-effective, when compared with traditional laparoscopy.