Total laparoscopic mesorectal excision versus robot-assisted in the treatment of rectal cancer: a meta-analysis

A systematic literature review and meta-analysis was performed using the MEDLINE, EMBASE and COCHRANE LIBRARY data bases, and identifying clinical trials, published between the years 2005 to 2010, that compared the short term results of conventional laparoscopic total mesorectal excision (L-TME) and robot-assisted total mesorectal excision (RA-TME) in the treatment of non-complicated rectal cancer. Five trials with a total of 380 patients were selected, of whom 169 were subjected to RA-TME and 211 to L-TME. No significant differences were found, although RA-TME was associated with a lower conversion rate, a greater resection margin circumference, and higher number of isolated lymph nodes, as well as a lower overall rate of complications. There was no evidence that RA-TME had advantages that compensated for the longer duration of the surgery and the higher cost of the procedure. More randomised prospective studies and a greater number of patients are needed. (C) 2011 AEC. Published by Elsevier Espana, S.L. All rights reserved.