Systematic review compares outcomes in robotic and laparoscopic surgery for rectal cancer, indicating robotic surgery may reduce complications and conversion rates.
Background Rectal cancer (RC) has the 10th highest cancer related deathrate worldwide. In the UK it is most commonly approached laparoscopically but robotic surgery is now seeing an increase in popularity. Robotic surgery for rectal cancer may be beneficial as it allows easier access to the deep and narrow pelvis alongside finer and more accurate dissection. Aim To compare outcomes of laparoscopic and robotic surgery for RC. Methods This systematic review searched PubMed, EMBASE and Cochrane library databases, to collate data on surgery for RC, both robotically and laparoscopically. Rates of conversion to open surgery, positive circumferential resection margin (+CRM), length of hospital stay (LHS) and complications were compared. Results 18 studies were included with a total number of 8,667 patients. Consensus favoured robotic surgery in conversion rate, LHS, and overall complication rate. Robotic surgery for RC was also demonstrated to be non-inferior to laparoscopy in relation to +CRM percentage. Conclusion Longitudinal studies of high-quality design need to be performed to assess reasons for heterogeneity between the results of this study. Studies assessing cost-benefit analysis between laparoscopic and robotic methods also need to be performed.
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Smith et al. (2025) studied this question.