Robotic versus Laparoscopic Liver Resections for Colorectal Metastases: A Systematic Review and Meta-Analysis.

Simple Summary: Colorectal cancer can be associated with liver metastasis and may be treated by minimal liver surgery using laparoscopic approaches and robotic surgery. Robotic surgery is of significant use in colorectal surgery and urology. However, there is still no long-term evidence concerning overall survival, and the number of patients operated on using this method remains small. Given the numerous benefits of robotic surgery and the concomitant small number of studies, we conducted a meta-analysis of the operative and short-term oncologic outcomes of laparoscopic versus robotic-assisted liver resection for colorectal liver metastases. The results of the meta-analysis show small differences in blood loss and conversion to open laparotomy rates in favor of robotic surgery. There were no differences in 30-day mortality, and there were also no differences in 1-year, 2-year, or 3-year mortality. The results indicate that both surgical methods are comparable in efficacy and safety. Colorectal cancer is the third most common cancer worldwide, and the liver is the most common localization of metastatic disease. The incidence of minimally invasive liver surgery is increasing, and robotic surgery (RLR) is believed to overcome some limitations of a laparoscopic approach (LRL). We performed a systematic review and meta-analysis of operative and short-term oncologic outcomes of the laparoscopic versus robotic-assisted liver resection for colorectal liver metastases. An online search of PubMed, Embase, Scopus, and the Cochrane databases was performed. Eight studies involving 3210 patients were considered eligible for the meta-analysis. In the LRL group, a higher conversion to open rate (12.4%) was observed compared to the RLR (6.7%; p = <0.001). 30-day mortality was 0.7% for the LRL group compared to 0.5% for the RLR group (p = 0.76). Mortality in longer periods among LLR and RLR amounted to 18.2% vs. 8.0% for 1-year mortality (p = 0.07), 34.1% vs. 26.7% for 2-year mortality (p = 0.13), and 52.3% vs. 48.3% for 3-year mortality (p = 0.46). The length of hospital stay was 5.6 ± 2.5 vs. 5.8 ± 2.1 days, respectively (p = 0.47). There were no significant differences between the incidence of individual complications in the LRL and RLR groups (p = 0.78). Laparoscopic or robotic approaches for colorectal liver metastases are comparable in terms of safety and effectiveness. There are significant advantages to robotic surgery, although there is still no long-term evidence concerning overall survival, and the number of patients operated on using RLR remains small. [ABSTRACT FROM AUTHOR]

Copyright of Cancers is the property of MDPI and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This abstract may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full abstract. (Copyright applies to all Abstracts.)