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Robotic right versus left colectomy for colorectal neoplasia: a systemic review and meta-analysis

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Abstract

Previous studies comparing right and left colectomies have shown variable short-term outcomes. Despite the rapid adoption of robotics in colorectal operations, few studies have addressed outcome differences between robotic right (RRC) and left (RLC) colectomies. Therefore, we sought to compare the short-term outcomes of RRC and RLC for neoplasia. This is a systematic review and meta-analysis of articles published from the time of inception of the datasets to May 1, 2022. The electronic databases included English publications in Ovid MEDLINE In-Process and Other Non-Indexed Citations, Ovid MEDLINE, Ovid EMBASE, and Scopus. A total of 13,514 patients with colon neoplasia enrolled in 9 comparative studies were included. The overall mean age was 64.1 years (standard deviation [SD] ± 9.8), and there was a minor female predominance (52% female vs. 48% male). 8656 (64.0%) underwent RRC and 4858 (36.0%) underwent RLC. The ASA score 1 of − 2 in the LRC group was 37% vs. 21% in the R. Whereas the ASA score 3–4 was 62% in the LRC vs. 76% in RRC. Moreover, the mean of the Charlson Comorbidity Score in the LRC was 4.3 (SD 1.9) vs. 3.1 (SD 2.3) in the RRC. Meta-analysis revealed a significantly higher rate of ileus in RRC (10%) compared to RLC (7%) (OR 1.46, 95% CI 1.27–1.67). Additionally, operative time was significantly shorter by 22.6 min in RRC versus LRC (95% CI − 37.4–7.8; p < 0.001). There were no statistically significant differences between RRC and RLC in conversion to open operation, estimated blood loss, wound infection, anastomotic leak, reoperation, readmission, and hospital length of stay. In this only meta-analysis comparing RRC and LRC for colon neoplasia, we found that RRC was independently associated with a shorter operative time but increased risk of ileus.

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Acknowledgements

This study received no external financial support.

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Authors and Affiliations

  1. Surgery Group Los Angeles, Los Angeles, CA, USA

    Paola Solis-Pazmino, Kimberly Oka, Kristina La, Orly Termeie, Jason Cohen, Moshe Barnajian & Yosef Nasseri

  2. Surgery Department, Santa Casa de Porto Alegre, Porto Alegre, RS, Brazil

    Paola Solis-Pazmino, Antonio Weston & Mayara Machry

  3. Knowledge and Evaluation Research Unit, Mayo Clinic, Rochester, MN, 55905, USA

    Paola Solis-Pazmino & Oscar Ponce

  4. CaTaLiNA-Cancer de Tiroides en Latino America, Quito, Ecuador

    Paola Solis-Pazmino, Oscar Ponce & Luis Figueroa

  5. Facultad de Ciencias Médicas, Universidad Central del Ecuador, Quito, Ecuador

    Luis Figueroa

  6. Cedars-Sinai Medical Center, Los Angeles, CA, USA

    Yosef Nasseri

Authors
  1. Paola Solis-Pazmino
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  2. Kimberly Oka
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Contributions

PS-P and YN Drafting/revising the manuscript for content, including medical writing for content; major role in data acquisition; study concept or design; analysis or interpretation of data. KO, KL, and OT contribute to data acquisition and manuscript revision. OP and LF contribute to the study concept, analysis, and interpretation of data. AW, MM, JC, and MB revised the manuscript.

Corresponding author

Correspondence to Paola Solis-Pazmino.

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Conflict of interest

Disclosures Paola Solis-Pazmino, Kimberly Oka, Kristina La, Orly Termeie, Oscar Ponce, Luis Figueroa, Antonio Weston, Mayara Machry, Jason Cohen, Moshe Barnajian, Yosef Nasseri have no conflicts with interest or financial ties to disclose.

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Solis-Pazmino, P., Oka, K., La, K. et al. Robotic right versus left colectomy for colorectal neoplasia: a systemic review and meta-analysis. J Robotic Surg 17, 1907–1915 (2023). https://doi.org/10.1007/s11701-023-01649-0

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