AUTHOR=Zhang Jie , Qi Xingshun , Yi Fangfang , Cao Rongrong , Gao Guangrong , Zhang Cheng 

TITLE=Comparison of Clinical Efficacy and Safety Between da Vinci Robotic and Laparoscopic Intersphincteric Resection for Low Rectal Cancer: A Meta-Analysis

JOURNAL=Frontiers in Surgery

VOLUME=8

YEAR=2021

URL=https://www.frontiersin.org/journals/surgery/articles/10.3389/fsurg.2021.752009

DOI=10.3389/fsurg.2021.752009

ISSN=2296-875X

ABSTRACT=<p><bold>Background and Aims:</bold> The intersphincteric resection (ISR) is beneficial for saving patients' anus to a large extent and restoring original bowel continuity. Laparoscopic ISR (L-ISR) has its drawbacks, such as two-dimensional images, low motion flexibility, and unstable lens. Recently, da Vinci robotic ISR (R-ISR) is increasingly used worldwide. The purpose of this article is to compare the feasibility, safety, oncological outcomes, and clinical efficacy of R-ISR vs. L-ISR for low rectal cancer.</p><p><bold>Methods:</bold> PubMed, EMBASE, Cochrane Library, and Web of Science were searched to identify comparative studies of R-ISR vs. L-ISR. Demographic, clinical, and outcome data were extracted. Mean difference (MD) and risk ratio (RR) with their corresponding confidence intervals (CIs) were calculated.</p><p><bold>Results:</bold> Five studies were included. In total, 510 patients were included, of whom 273 underwent R-ISR and 237 L-ISR. Compared with L-ISR, R-ISR has significantly lower estimated intraoperative blood loss (MD = −23.31, 95% CI [−41.98, −4.64], <italic>P</italic> = 0.01), longer operative time (MD = 51.77, 95% CI [25.68, 77.86], <italic>P</italic> = 0.0001), hospitalization days (MD = −1.52, 95% CI [−2.10, 0.94], <italic>P</italic> &lt; 0.00001), and postoperative urinary complications (RR = 0.36, 95% CI [0.16, 0.82], <italic>P</italic> = 0.02).</p><p><bold>Conclusions:</bold> The potential benefits of R-ISR are considered as a safe and feasible alternative choice for the treatment of low rectal tumors.</p>