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CC BY 4.0 · Journal of Coloproctology 2024; 44(S 01): S1-S138
DOI: 10.1055/s-0045-1808683
Câncer do Cólon/Reto/Ânus
Colon/Rectal/Anus Cancer
ID – 141125
E-poster

ROBOTIC VS OPEN SURGERY FOR SIMULTANEOUS RESECTION OF COLORECTAL CANCER AND LIVER METASTASES: A SYSTEMATIC REVIEW AND META ANALYSIS

Bruna Oliveira Trindade
1   UFCPSA
,
Antônio Nocchi Kalil
2   Santa Casa de Porto Alegre, Porto Alegre, Brasil
,
Fares Hassan Hamaoui
2   Santa Casa de Porto Alegre, Porto Alegre, Brasil
,
Cristina Calloni
3   Universidade Feevale, Rio Grande do Sul, Brasil
,
Daniel de Barcellos Azambuja Patrícia Marcolin
2   Santa Casa de Porto Alegre, Porto Alegre, Brasil
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    Introduction For patients with resectable colorectal liver metastases (CLM), surgery offers the best long-term survival and potential cure. Synchronous resection is preferred, but while colorectal surgeries are often laparoscopic, minimally invasive CLM resections are not yet standard. The emergence of robotic surgery introduces new possibilities, but its impact on surgical outcomes compared to traditional open surgery is still debated, with various studies providing conflicting results. To address this uncertainty, we conducted a systematic review and meta-analysis to compare the surgical outcomes of robotic versus open simultaneous resections for colorectal cancer and liver metastases.

    Methods A comprehensive search of PubMed, Embase, and Cochrane databases was conducted to identify studies comparing robotic and open surgery for simultaneous resection of colorectal cancer and liver metastases. The primary outcomes were (1) operative time; (2) anastomotic leakage; (3) bile leakage; (4) blood loss; and (5) postoperative hospital stays. Heterogeneity was examined with I2 statistics. Odds ratios (ORs), mean Differences (MD) and their 95% confidence intervals (CIs) were computed with the use of a random-effects model.

    Results From a total of 582 studies, we included 5 studies with 1,696 patients, of whom 165 (9.73%) underwent a robotic surgery approach. The blood loss (MD -87.48; 95% CI [-103.76, -71.21]; p< 0.0001), postoperative hospital stays (MD -2.23; 95% CI [-2.96,-1.51]; p< 0.0001) were statistically significant lower in patients treated by robotic platform. On the other hand, operative time was higher in the open surgery group (MD 48.87; 95% CI [21.23,76.50]; p=0.0005). Anastomotic leakage (OD 1.66; 95% CI [0.65,4.26]; p=0.29) and bile leakage (OR 0.57; 95% CI [0.57,3.98]; p=0.57) did not show a statistically significant difference between the groups.

    Conclusion This comprehensive systematic review and meta-analysis provides evidence that robotic approaches yield improved outcomes for patients undergoing simultaneous resection of colorectal cancer and liver metastases. New studies are needed to evaluate new outcomes.


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    No conflict of interest has been declared by the author(s).

    Publication History

    Article published online:
    25 April 2025

    © 2025. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution 4.0 International License, permitting copying and reproduction so long as the original work is given appropriate credit (https://creativecommons.org/licenses/by/4.0/)

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