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Robotic colectomy with CME versus laparoscopic colon resection with or without CME for colon cancer: a systematic review and meta-analysis

Introduction - This systematic review with meta-analysis aimed to compare the robotic complete mesocolon excision (RCME) to laparoscopic colectomy (LC) with (LCME) or without CME (LC non-CME) in postoperative outcomes, harvested lymph nodes and disease-free survival. - Methods - We performed a syste...

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Main Authors: Oweira, Hani (Author) , Reißfelder, Christoph (Author) , Elhadedy, H (Author) , Rahbari, Nuh Nabi (Author) , Mehrabi, Arianeb (Author) , Fattal, Mohamad Wahid (Author) , Khan, JS (Author) , Chaouch, MA (Author)
Format: Article (Journal)
Language:English
Published: February 2023
In: Annals of the Royal College of Surgeons of England
Year: 2023, Volume: 105, Issue: 2, Pages: 113-125
ISSN:1478-7083
DOI:10.1308/rcsann.2022.0051
Online Access:Verlag, lizenzpflichtig, Volltext: https://doi.org/10.1308/rcsann.2022.0051
Verlag, lizenzpflichtig, Volltext: https://publishing.rcseng.ac.uk/doi/10.1308/rcsann.2022.0051
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Author Notes:H Oweira, C Reissfelder, H Elhadedy, N Rahbari, A Mehrabi, W Fattal, JS Khan, MA Chaouch
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Summary:Introduction - This systematic review with meta-analysis aimed to compare the robotic complete mesocolon excision (RCME) to laparoscopic colectomy (LC) with (LCME) or without CME (LC non-CME) in postoperative outcomes, harvested lymph nodes and disease-free survival. - Methods - We performed a systematic review with meta-analysis according to PRISMA 2020 and AMSTAR 2 guidelines. - Results - The literature search yielded seven comparative studies including 677 patients: 269 patients in the RCME group and 408 in the LC group. The pooled analysis concluded to a lower conversion rate in the RCME group (OR=0.17; 95% CI [0.04, 0.74], p=0.02). There was no difference between the two groups in terms of morbidity (OR=1.03; 95% CI [0.70, 1.53], p=0.87), anastomosis leakage (OR=0.83; 95% CI [0.18, 3.72], p=0.81), bleeding (OR=1.90; 95% CI [0.64, 5.58], p=0.25), wound infection (OR=1.37; 95% CI [0.51, 3.68], p=0.53), operative time (mean difference (MD)=36.32; 95% CI [−24.30, 96.93], p=0.24), hospital stay (MD=−0.94; 95% CI [−2.03, 0.15], p=0.09) and disease-free survival (OR=1.29; 95% CI [0.71, 2.35], p=0.41). In the subgroup analysis, the operative time was significantly shorter in the LCME group than RCME group (MD=50.93; 95% CI [40.05, 61.81], p<0.01) and we noticed a greater number of harvested lymph nodes in the RCME group compared with LC non-CME group (MD=8.96; 95% CI [5.98, 11.93], p<0.01). - Conclusions - The robotic approach for CME ensures a lower conversion rate than the LC. RCME had a longer operative time than the LCME subgroup and a higher number of harvested lymph nodes than the LC non-CME group.
Item Description:Online veröffentlicht: 11. August 2022
Gesehen am 01.07.2024
Physical Description:Online Resource
ISSN:1478-7083
DOI:10.1308/rcsann.2022.0051

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