Comparison of clinical efficacy of robotic right colectomy and laparoscopic right colectomy for right colon tumor

Abstract

Abstract Background: The purpose of this study was to compare the clinical efficacy of robotic right colectomy (RRC) and laparoscopic right colectomy (LRC) in the treatment of right colon tumor. Methods: We systematically searched PubMed, Web of science, EMBASE ClinicalTrials.gov and Cochrane Central Register for studies (studies published between January 2011 and June 2020). The included studies compared the clinical efficacy of RRC and LRC in the treatment of right colon tumor, and analyzed the perioperative data. Results: Our meta-analysis included 10 studies involving 1180 patients who underwent 2 surgical procedures, RRC and LRC. This study showed that compared with LRC, there was no significant difference in first flatus passage (weighted mean difference [WMD]: −0.37, 95% CI: −1.09–0.36, P\u200a=\u200a.32), hospital length of stay (WMD: −0.23, 95% CI: −0.73–0.28, P\u200a=\u200a.32), reoperation (OR: 1.66, 95% CI: 0.67–4.10, P\u200a=\u200a.27), complication (OR: 0.83, 95% CI: 0.60–1.14, P\u200a=\u200a.25), mortality (OR: 0.45, 95% CI: 0.02–11.22, P\u200a=\u200a.63), wound infection (OR: 0.65, 95% CI: 0.34–1.25, P\u200a=\u200a.20), and anastomotic leak (OR: 0.73, 95% CI: 0.33–1.63, P\u200a=\u200a.44). This study showed that compared with LRC, the lymph nodes retrieved (WMD: 1.47, 95% CI: −0.00–2.94, P\u200a=\u200a.05) of RRC were similar, with slight advantages, and resulted in longer operative time (WMD: 65.20, 95% CI: 53.40–77.01, P\u200a<\u200a.00001), less estimated blood loss (WMD: −13.43, 95% CI: −20.65–6.21, P\u200a=\u200a.0003), and less conversion to open surgery (OR: 0.30, 95% CI: 0.17–0.54, P\u200a<\u200a.0001). Conclusions: RRC is equivalent to LRC with respect to first flatus passage, hospital length of stay, reoperation, complication, and results in less conversion to LRC.