Comparison of Postoperative Complications Between Robotic and Laparoscopic Rectal Cancer Surgery

Abstract Objective: Robotic and laparoscopic surgery for rectal cancer have been applied in clinic for decades, nevertheless, which surgical approach has a lower rate of postoperative complications is still inconclusive. Therefore, the aim of this meta-analysis is to compare the postoperative complications between robotic and laparoscopic rectal cancer surgery based on randomized controlled trials.Methods: Randomized controlled trials (until May 2020) which compared robotic and laparoscopic rectal cancer surgery were searched through PubMed, EMbase, Cochrane library, CNKI, Wan Fang databases and CBM. Data regarding sample size, clinical and demographic characteristics, overall postoperative complications, and the incidence of anastomotic leakage、incision infection、bleeding、 ileus、respiratory complications、 urinary complications、unscheduled reoperation 、perioperative mortality were extracted. The results were analyzed using RevMan v5.3.Results: Seven randomized controlled trials which included 507 robotic and 516 laparoscopic rectal cancer surgery cases were included. Meta-analysis showed that the overall postoperative complications [Z=1.1，OR=1.18，95% CI (0.88-1.57), P=0.27], anastomotic leakage [Z=0.96, OR=1.27, 95% CI (0.78-2.08), P=0.34], incision infection [Z=0.18, OR=1.05, 95% CI (0.61-1.79), P=0.86], bleeding [Z=0.19, OR=0.89, 95% CI (0.27-2.97), P=0.0.85], ileus [Z=1.47, OR=0.66, 95% CI (0.38-1.15), P=0.14], respiratory complications [Z=0.84, OR=0.64, 95% CI (0.22-1.82), P=0.40], urinary complications [Z=0.66, OR=1.22, 95% CI (0.67-2.22),P=0.51], unscheduled reoperation [Z=0.14, OR=0.91, 95% CI (0.26-3.20), P=0.89], perioperative mortality [Z=0.28, OR=0.79, 95% CI (0.15-4.12), P=0.78] were similar between robotic and laparoscopic rectal surgery.Conclusion: Robotic surgery for rectal cancer was comparable to laparoscopic surgery with respect to postoperative complications.