Journal
INTERNATIONAL JOURNAL OF MEDICAL ROBOTICS AND COMPUTER ASSISTED SURGERY
Volume 17, Issue 6, Pages -Publisher
WILEY
DOI: 10.1002/rcs.2329
Keywords
anorectal function; laparoscopy; LARS; minimally-invasive surgery; rectal cancer; rectal resection; robotic surgery; total mesorectal excision
Categories
Funding
- Intuitive Surgical Sarl
- Projekt DEAL
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Robotic TME leads to better recovery of anorectal function compared to laparoscopic, open, and transanal techniques. Further high-quality studies are needed to confirm the benefits of robotic surgery.
Background Improving survival rates in rectal cancer patients has generated a growing interest in functional outcomes after total mesorectal excision (TME). The well-established low anterior resection syndrome (LARS) score assesses postoperative anorectal impairment after TME. Our meta-analysis is the first to compare bowel function after open, laparoscopic, transanal, and robotic TME. Methods All studies reporting functional outcomes after rectal cancer surgery (LARS score) were included, and were compared with a consecutive series of robotic TME (n = 48). Results Thirty-two publications were identified, including 5 565 patients. Anorectal function recovered significantly better within one year after robotic TME (3.8 [95%CI -9.709-17.309]) versus laparoscopic TME (26.4 [95%CI 19.524-33.286]), p = 0.006), open TME (26.0 [95%CI 24.338-29.702], p = 0.002) and transanal TME (27.9 [95%CI 22.127-33.669], p = 0.003). Conclusions Robotic TME enables better recovery of anorectal function compared to other techniques. Further prospective, high-quality studies are needed to confirm the benefits of robotic surgery.
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