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

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.

• Authors: Alberto Zarak, Alvaro Castillo, Kandace Kichler, Lucy de la Cruz, Leonardo Tamariz, Srinivas Kaza
• Journal: Surgical endoscopy (Surg Endosc) Vol. 29 Issue 6 Pg. 1341-7 (Jun 2015) ISSN: 1432-2218 [Electronic] Germany
• PMID: 25847139 (Publication Type: Journal Article, Meta-Analysis)

Topics

• Colectomy (adverse effects, methods)
• Colonic Diseases (surgery)
• Humans
• Laparoscopy (adverse effects, methods)
• Length of Stay
• Postoperative Complications
• Robotic Surgical Procedures (adverse effects, methods)