Systematic Review
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World J Gastrointest Oncol. Jun 15, 2014; 6(6): 184-193
Published online Jun 15, 2014. doi: 10.4251/wjgo.v6.i6.184
Robotic surgery for rectal cancer: A systematic review of current practice
Tony Wing Chung Mak, Janet Fung Yee Lee, Kaori Futaba, Sophie Sok Fei Hon, Dennis Kwok Yu Ngo, Simon Siu Man Ng
Tony Wing Chung Mak, Janet Fung Yee Lee, Sophie Sok Fei Hon, Dennis Kwok Yu Ngo, Simon Siu Man Ng, Division of Colorectal Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, Hong Kong, China
Kaori Futaba, Department of Colorectal Surgery, University Hospital Birmingham NHS Trust, Birmingham, B15 2TH, United Kingdom
Author contributions: Mak TWC, Lee JFY, Futaba K, Hon SSF, Ngo DKY, Ng SSM contributed to conceptualisation of the study, literature searches, identification of relevant articles, analysing the collected data and writing of the paper; all authors contributed equally to this work.
Correspondence to: Simon Siu Man Ng, MD, FRCS, Professor of Colorectal Surgery, Division of Colorectal Surgery, Department of Surgery, The Chinese University of Hong Kong, Prince of Wales Hospital, Room 64045, 4/F, Lui Che Woo Clinical Sciences Building, 30-32 Ngan Shing Street, Shatin, New Territories, Hong Kong, China. simonng@surgery.cuhk.edu.hk
Telephone: +85-2-26321495 Fax: +85-2-26377974
Received: December 25, 2013
Revised: February 23, 2014
Accepted: April 17, 2014
Published online: June 15, 2014
Processing time: 176 Days and 21.5 Hours
Abstract

AIM: To give a comprehensive review of current literature on robotic rectal cancer surgery.

METHODS: A systematic review of current literature via PubMed and Embase search engines was performed to identify relevant articles from january 2007 to november 2013. The keywords used were: “robotic surgery”, “surgical robotics”, “laparoscopic computer-assisted surgery”, “colectomy” and “rectal resection”.

RESULTS: After the initial screen of 380 articles, 20 papers were selected for review. A total of 1062 patients (male 64.0%) with a mean age of 61.1 years and body mass index of 24.9 kg/m2 were included in the review. Out of 1062 robotic-assisted operations, 831 (78.2%) anterior and low anterior resections, 132 (12.4%) intersphincteric resection with coloanal anastomosis, 98 (9.3%) abdominoperineal resections and 1 (0.1%) Hartmann’s operation were included in the review. Robotic rectal surgery was associated with longer operative time but with comparable oncological results and anastomotic leak rate when compared with laparoscopic rectal surgery.

CONCLUSION: Robotic colorectal surgery has continued to evolve to its current state with promising results; feasible surgical option with low conversion rate and comparable short-term oncological results. The challenges faced with robotic surgery are for more high quality studies to justify its cost.

Keywords: Rectal cancer; Robotics; Minimal invasive surgery; Systematic review; Rectal surgery

Core tip: This systematic review summarizes current evidence on the role of robotic surgery for the treatment of rectal cancer. It is a timely article as minimal invasive surgery has proven to benefit patients with colonic cancers but conventional laparoscopic surgery for the treatment for rectal cancer remains controversial due to its steep learning curve. Robotic-assisted surgery has technological advances, which may have the potential to overcome some of the limitations of conventional laparoscopic surgery.