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Robotic right versus left colectomy for colorectal neoplasia: a systemic review and meta-analysis.

Authors :
Solis-Pazmino, Paola
Oka, Kimberly
La, Kristina
Termeie, Orly
Ponce, Oscar
Figueroa, Luis
Weston, Antonio
Machry, Mayara
Cohen, Jason
Barnajian, Moshe
Nasseri, Yosef
Source :
Journal of Robotic Surgery; Oct2023, Vol. 17 Issue 5, p1907-1915, 9p
Publication Year :
2023

Abstract

Previous studies comparing right and left colectomies have shown variable short-term outcomes. Despite the rapid adoption of robotics in colorectal operations, few studies have addressed outcome differences between robotic right (RRC) and left (RLC) colectomies. Therefore, we sought to compare the short-term outcomes of RRC and RLC for neoplasia. This is a systematic review and meta-analysis of articles published from the time of inception of the datasets to May 1, 2022. The electronic databases included English publications in Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, and Scopus. A total of 13,514 patients with colon neoplasia enrolled in 9 comparative studies were included. The overall mean age was 64.1 years (standard deviation [SD] ± 9.8), and there was a minor female predominance (52% female vs. 48% male). 8656 (64.0%) underwent RRC and 4858 (36.0%) underwent RLC. The ASA score 1 of − 2 in the LRC group was 37% vs. 21% in the R. Whereas the ASA score 3–4 was 62% in the LRC vs. 76% in RRC. Moreover, the mean of the Charlson Comorbidity Score in the LRC was 4.3 (SD 1.9) vs. 3.1 (SD 2.3) in the RRC. Meta-analysis revealed a significantly higher rate of ileus in RRC (10%) compared to RLC (7%) (OR 1.46, 95% CI 1.27–1.67). Additionally, operative time was significantly shorter by 22.6 min in RRC versus LRC (95% CI − 37.4–7.8; p < 0.001). There were no statistically significant differences between RRC and RLC in conversion to open operation, estimated blood loss, wound infection, anastomotic leak, reoperation, readmission, and hospital length of stay. In this only meta-analysis comparing RRC and LRC for colon neoplasia, we found that RRC was independently associated with a shorter operative time but increased risk of ileus. [ABSTRACT FROM AUTHOR]

Details

Language :
English
ISSN :
18632483
Volume :
17
Issue :
5
Database :
Complementary Index
Journal :
Journal of Robotic Surgery
Publication Type :
Academic Journal
Accession number :
171844630
Full Text :
https://doi.org/10.1007/s11701-023-01649-0