Successful patient‐oriented surgical outcomes in robotic vs laparoscopic right hemicolectomy for cancer – a systematic review

• Published in: Colorectal disease 2020-05, Vol.22 (5), p.488-499
• Main Authors: Waters, P. S., Cheung, F. P., Peacock, O., Heriot, A. G., Warrier, S. K., O'Riordain, D. S., Pillinger, S., Lynch, A. C., Stevenson, A. R. L.
• Format: Article
• Language: English
• Subjects: Anastomotic leak; Cancer; Colon; Colon cancer; Hernia; Hernias; laparoscopic right hemicolectomy; Laparoscopy; Lymph nodes; Lymphatic system; Malignancy; Morbidity; Mortality; Patients; Pelvis; Quality of life; right hemicolectomy; Robotic surgery; Studies; successful patient‐oriented surgical outcomes; Surgery; Surgical outcomes; Surgical site infections; Wound infection
• ISSN: 1462-8910; 1463-1318
• DOI: 10.1111/codi.14822

Aim Minimally invasive surgical approaches for cancer of the right colon have been well described with significant patient and equivalent oncological benefits. Robotic surgery has advanced in its ability to provide multi‐quadrant abdominal access, leading the surgical community to widen its application outside of the pelvis to other abdominal compartments. Globally it is being realized that a patient's surgical episode of care is becoming the epicentre of cancer treatment. In order to establish the role of robotic surgery in a patient's episode of care, ‘successful patient‐oriented surgical’ parameters in right hemicolectomy for malignancy were measured. The objective was to examine the rates of successful patient‐oriented surgical outcomes in robotic right hemicolectomy (RRH) compared to laparoscopic right hemicolectomy (LRH) for cancer. Methods A systematic search of MEDLINE (Ovid: 1946–present), PubMed (NCBI), Embase (Ovid: 1966–present) and Cochrane Library was conducted using PRISMA for parameters of successful patient‐oriented surgical outcomes in RRH and LRH for malignancy alone. The parameters measured included postoperative ileus, anastomotic complication, surgical wound infection, length of stay (LOS), incisional hernia rate, conversion to open, margin status, lymph node harvest and overall morbidity and mortality. Results There were 15 studies which included 831 RRH patients and 3241 LRH patients, with a median age of 62–74 years. No study analysed the concept of successful patient‐oriented surgical outcomes. There was no significant difference in the incidence of postoperative ileus, with less time to first flatus in RRH (2.0–2.7 days, compared with 2.5–4.0 days, P